NPIMap

Organization Active NPI

The Commonwealth of Massachusetts

  • Long Term Care Hospital
  • Jamaica Plain, MA
National Provider Identifier
1174699458
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
Legal business name
THE COMMONWEALTH OF MASSACHUSETTS
Practice address
170 Morton Street
Jamaica Plain, MA 02130-3735
Phone
(617) 522-8110
Fax
(617) 971-3850
NPI assigned
Nov 28, 2006
Organization subpart
Yes
Parent organization
THE COMMONWEALTH OF MASSACHUSETTSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Authorized official

Name
Valenda Liptak
Title
Bureau Director, Public Health Hosp
Phone
(413) 784-9186

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Chronic Disease Hospital 281P00000X
Long Term Care Hospital 282E00000X Primary

Addresses

Primary practice location

170 Morton Street
Jamaica Plain, MA 02130-3735

Mailing address

170 Morton Street
Jamaica Plain, MA 02130-3735
Phone (617) 522-8110

Other identifiers 2

IdentifierTypeStateIssuer
110078189CMedicaidMA
9780319MedicaidMA

Other names 1

  • Lemuel Shattuck Hospital Doing business as

National Provider Directory

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

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

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648425600000",
    "number": "1174699458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MORTON STREET",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-522-8110",
            "fax_number": "617-971-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MORTON STREET",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-522-8110",
            "fax_number": "617-971-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COMMONWEALTH OF MASSACHUSETTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE COMMONWEALTH OF MASSACHUSETTS",
        "enumeration_date": "2006-11-28",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A",
        "authorized_official_last_name": "LIPTAK",
        "authorized_official_first_name": "VALENDA",
        "authorized_official_title_or_position": "BUREAU DIRECTOR, PUBLIC HEALTH HOSP",
        "authorized_official_telephone_number": "413-784-9186"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "281P00000X",
            "taxonomy_group": "",
            "desc": "Chronic Disease Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110078189C",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9780319",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lemuel Shattuck Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamaica Plain, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.