NPIMap

Organization Active NPI

Cambridge Public Health Commission

Doing business as Cambridge HLTH Alliance Outpatient Phcy East Cambridge

  • Community/Retail Pharmacy
  • East Cambridge, MA
National Provider Identifier
1164878013
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
DS90039 Issued in MA
Legal business name
CAMBRIDGE PUBLIC HEALTH COMMISSION
Doing business as
Cambridge HLTH Alliance Outpatient Phcy East Cambridge
Practice address
163 Gore St
East Cambridge, MA 02141-1119
Phone
(617) 499-6690
Fax
(617) 499-6691
NPI assigned
May 10, 2016
Last updated
Nov 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Authorized official

Name
Mrs. Maria Kossilos, MARIA KOSSILOS BS INNPI 1982988705
Title
Associate Chief Pharmacy Officer
Phone
(617) 806-8505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X DS90039 MA Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

163 Gore St
East Cambridge, MA 02141-1119

Mailing address

163 Gore St
East Cambridge, MA 02141-1119
Phone (617) 499-6690

Other names 1

  • CAMBRIDGE HLTH ALLIANCE OUTPATIENT PHCY EAST CAMBRIDGE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200914000845 MA Part B Supplier - Pharmacy 8921910894 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Revere, MA; Cambridge, MA; Medford, MA; Malden, MA

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
The Cambridge Hospital44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Practitioners & affiliated clinicians

Practitioners 1

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": "1462838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1164878013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 GORE ST",
            "city": "EAST CAMBRIDGE",
            "state": "MA",
            "postal_code": "021411119",
            "telephone_number": "617-499-6690",
            "fax_number": "617-499-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 GORE ST",
            "city": "EAST CAMBRIDGE",
            "state": "MA",
            "postal_code": "021411119",
            "telephone_number": "617-499-6690",
            "fax_number": "617-499-6691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMBRIDGE PUBLIC HEALTH COMMISSION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-10",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "KOSSILOS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "ASSOCIATE CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "617-806-8505",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MARIA KOSSILOS BS IN"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "DS90039",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMBRIDGE HLTH ALLIANCE OUTPATIENT PHCY EAST CAMBRIDGE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CAMBRIDGE HLTH ALLIANCE OUTPATIENT PHCY EAST CAMBRIDGE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.