NPIMap

Organization Active NPI

Boston Health Care for the Homeless Program, Inc.

  • Federally Qualified Health Center (FQHC)
  • Boston, MA
National Provider Identifier
1013131804
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
4681 Issued in MA
Legal business name
BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM, INC.
Practice address
780 Albany St
Boston, MA 02118-2755
Phone
(857) 654-1000
Fax
(857) 654-1100
NPI assigned
Apr 12, 2007
Last updated
May 24, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Agnes W Leung
Title
Chief Financial Officer
Phone
(857) 654-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 4681 MA Primary

Addresses

Primary practice location

780 Albany St
Boston, MA 02118-2755

Mailing address

780 Albany St
Boston, MA 02118-2755
Phone (857) 654-1227

Other names 1

  • Barbara McInnis House Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080514000342 MA Part A Provider - Federally Qualified Health Center (FQHC) 2668475419 Practice locations: Boston, MA
O20110527000309 MA Part B Supplier - Clinic/Group Practice 2668475419 Receives reassigned benefits from 139 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Roxbury, MA; Quincy, MA; Jamaica Plain, MA; Boston, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013131804. Details of each certification follow.

Federally qualified health center certification: CCN 221816

Legal name
BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM, INC.
Doing business as
MCINNIS HEALTH GROUP
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 1, 1993
Last certification
Feb 1, 1993
Ownership / control type
For profit – corporation
Most recent change of ownership
Jul 1, 1996 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Jun 5, 1992 in MA
Enrollment address
780 Albany St 2000
Boston, MA 21182524

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Steve Tringale Individual Corporate Director Jul 8, 2008
Deion Scott Hawkins Individual Corporate DirectorBoard Member Jul 11, 2023 5%
Sara Gaia Reid Individual Corporate DirectorBoard Member May 12, 2015 5%
Derek Winbush Individual Corporate Director Sep 14, 2010
Paul Jeremiah Selian Individual Corporate DirectorBoard Member Jul 11, 2023 5%
Alice Kenney Walsh Individual Corporate DirectorBoard Member Jan 13, 2026 5%
Brett Painchaud Individual Corporate Director Jul 1, 2008
Denise de Las Nueces Individual Corporate OfficerCeo Apr 14, 2026
W-2 Managing Employee Jul 9, 2012
Joanne M Guarino Individual Corporate DirectorBoard Member Jun 12, 2012 5%
Steven Myles Walsh Individual Corporate DirectorBoard Member Jan 12, 2016 5%
Thomas Dehner Individual Corporate Director Aug 9, 2011
Barbara Blakeney Individual Corporate Director Jul 14, 2009
Francis Hyatt Individual Corporate DirectorBoard Member Nov 12, 2019 5%
Agnes Leung Individual Corporate OfficerCfo Jun 13, 2000
W-2 Managing Employee Jul 8, 2008
Ryan William O'Donnell Individual Corporate DirectorBoard Member Aug 14, 2018 5%
Valeria Anita Ramdin Individual Corporate OfficerBoard Member Jul 12, 2016

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527120000000",
    "number": "1013131804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182755",
            "telephone_number": "857-654-1227",
            "fax_number": "857-654-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182755",
            "telephone_number": "857-654-1000",
            "fax_number": "857-654-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2018-05-24",
        "status": "A",
        "authorized_official_last_name": "LEUNG",
        "authorized_official_first_name": "AGNES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "857-654-1200"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MA",
            "license": "4681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Barbara McInnis House",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Barbara McInnis House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.