NPIMap

Organization Active NPI

Commonwealth of Massachusetts

  • Case Management Agency
  • Boston, MA
National Provider Identifier
1104943885
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
COMMONWEALTH OF MASSACHUSETTS
Practice address
25 Staniford St
Boston, MA 02114-2503
Phone
(617) 626-8501
Fax
(617) 626-8515
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ros Simon
Title
Site Director
Phone
(617) 626-8501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

25 Staniford St
Boston, MA 02114-2503

Mailing address

25 Staniford St
Boston, MA 02114-2503
Phone (617) 626-8501

Other identifiers 1

IdentifierTypeStateIssuer
1802224MedicaidMA

Other names 1

  • Department of Mental Health - Lindemann Mental Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
C Stanley Raymond146 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

25 Staniford St
Boston, MA 02114
Phone (617) 626-8500

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104943885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 STANIFORD ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142503",
            "telephone_number": "617-626-8501",
            "fax_number": "617-626-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 STANIFORD ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142503",
            "telephone_number": "617-626-8501",
            "fax_number": "617-626-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF MASSACHUSETTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "ROS",
        "authorized_official_title_or_position": "SITE DIRECTOR",
        "authorized_official_telephone_number": "617-626-8501"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1802224",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Department of Mental Health - Lindemann Mental Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.