NPIMap

Organization Active NPI

Manet Community Health Center, Inc.

Doing business as Manet Community Health Center, Inc. at Quincy Medical Center

  • Federally Qualified Health Center (FQHC)
  • Quincy, MA
National Provider Identifier
1093746828
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
4801 Issued in MA
Legal business name
MANET COMMUNITY HEALTH CENTER, INC.
Doing business as
Manet Community Health Center, Inc. at Quincy Medical Center
Practice address
114 Whitwell St
2ND Floor
Quincy, MA 02169-1870
Phone
(617) 376-2088
Fax
(617) 376-2089
NPI assigned
Jul 6, 2006
Last updated
Mar 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Authorized official

Name
Cynthia Sierra
Title
Chief Executive Officer
Phone
(617) 404-4101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 4801 MA Primary

Addresses

Primary practice location

114 Whitwell St
2ND Floor
Quincy, MA 02169-1870

Mailing address

110 W Squantum St
North Quincy, MA 02171-2122
Phone (617) 376-3030

Other identifiers 1

IdentifierTypeStateIssuer
1300563MedicaidMA

Other names 1

  • Manet Community Health Center, Inc. at Quincy Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093746828. Details of each certification follow.

  • CCN 221864 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 221864

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MANET COMMUNITY HEALTH CENTER INC QUINCY MED CTR
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 16, 2005
Last certification
Mar 16, 2005
Ownership / control type
For profit – corporation
Facility address
114 Whitwell Street 2ND Floor
Quincy, MA 02169

National Provider Directory

National Provider Directory
Tax ID family
Manet Community Health Center Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

114 Whitwell St
Fl 2
Quincy, MA 02169
Phone (617) 376-2088

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1093746828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W SQUANTUM ST",
            "city": "NORTH QUINCY",
            "state": "MA",
            "postal_code": "021712122",
            "telephone_number": "617-376-3030",
            "fax_number": "617-774-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WHITWELL ST",
            "address_2": "2ND FLOOR",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021691870",
            "telephone_number": "617-376-2088",
            "fax_number": "617-376-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANET COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "SIERRA",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-404-4101"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MA",
            "license": "4801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1300563",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manet Community Health Center, Inc. at Quincy Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Manet Community Health Center, Inc. at Quincy Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.