NPIMap

Organization Active NPI

North Suffolk Community Services Inc.

  • Developmental Disabilities Clinic/Center
  • East Boston, MA
National Provider Identifier
1255481107
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
License
CERTIFIED BY DPH Issued in MA
Legal business name
NORTH SUFFOLK COMMUNITY SERVICES INC.
Practice address
130 Condor St
East Boston, MA 02128-1305
Phone
(617) 569-6560
Fax
(617) 569-1856
NPI assigned
Jan 11, 2007
Last updated
May 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Authorized official

Name
Judi Lemoine
Title
Chief Executive Officer
Phone
(617) 912-7910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X CERTIFIED BY DPH MA Primary

Addresses

Primary practice location

130 Condor St
East Boston, MA 02128-1305

Mailing address

301 Broadway
Chelsea, MA 02150-2807
Phone (617) 889-4860

Other identifiers 10

IdentifierTypeStateIssuer
612900OtherMAHARVARD PILGRIM
0006844OtherMANEIGHBORHOOD HEALTH PLAN
1800515MedicaidMA
3836587OtherCTCIGNA
708502OtherMATUFTS HEALTH PLAN
EI0002OtherMABLUE CROSS OF MA
00000005443OtherMABMC HEALTHNET-EI
42317215002OtherTRICARE-CHAMPUS
99625101OtherMANETWORK HEALTH
821870OtherCTAETNA-US HEALTHCARE

Other names 1

  • North Suffolk Mental Health Association, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
North Suffolk Community Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

530 Border St
East Boston, MA 02128
Phone (617) 569-6560

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1255481107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BROADWAY",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "021502807",
            "telephone_number": "617-889-4860",
            "fax_number": "617-889-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CONDOR ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281305",
            "telephone_number": "617-569-6560",
            "fax_number": "617-569-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SUFFOLK COMMUNITY SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "LEMOINE",
        "authorized_official_first_name": "JUDI",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-912-7910"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "MA",
            "license": "CERTIFIED BY DPH",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "612900",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0006844",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1800515",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3836587",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "708502",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MA",
            "identifier": "EI0002",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET-EI",
            "identifier": "00000005443",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE-CHAMPUS",
            "identifier": "42317215002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "99625101",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA-US HEALTHCARE",
            "identifier": "821870",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Suffolk Mental Health Association, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in East Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.