NPIMap

Organization Active NPI

Northeast Hospital Corporation

  • General Acute Care Hospital
  • Beverly, MA
National Provider Identifier
1316917941
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
15 Issued in MA
Legal business name
NORTHEAST HOSPITAL CORPORATION
Practice address
85 Herrick St
Beverly Hospital
Beverly, MA 01915-1776
Phone
(978) 922-3000
Fax
(978) 921-7071
NPI assigned
Jan 25, 2006
Last updated
Sep 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Authorized official

Name
Mr. Philip Cormier
Title
Ceo
Phone
(978) 922-3000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X V93D MA
General Acute Care Hospital 282N00000X 15 MA Primary

Addresses

Primary practice location

85 Herrick St
Beverly Hospital
Beverly, MA 01915-1776

Mailing address

85 Herrick St
Beverly Hospital
Beverly, MA 01915-1776
Phone (978) 922-3000

Other identifiers 18

IdentifierTypeStateIssuer
1000039MedicaidMA
2222003301OtherMABC HMO/PHO INPAT
901790OtherMATUFTS PHO INPAT
9343OtherMAAETNA HMO
BEV2222003301OtherMAHMO BLUE INPAT
S005394OtherMACHAMPUS
2222003311OtherMABC HMO/PHO OUTPAT
901790OtherMATUFTS MCR INPAT
0007079MedicaidMA
2222003301OtherMABC INDEM INPAT
900385OtherMAFIRST SENIORITY
1202626MedicaidMA
2222003311OtherMABC INDEM OUTPAT
900082OtherMATUFTS MCR OUTPAT
1000039MedicaidMD
900082OtherMATUFTS PHO OUTPAT
900385OtherMAHARVARD PILGRIM HMO
BEV2222003311OtherMAHMO BLUE OUTPAT

Other names 1

  • Northeast Hospital Corporation Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040420001051 MA Part B Supplier - Clinic/Group Practice 1153213202 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Danvers, MA
O20061205000105 MA Part A Provider - Hospital 1153213202 1 other NPI on this enrollment
Practice locations: Burlington, MA; Beverly, MA; Gloucester, MA; Danvers, MA; Manchester, MA; Newburyport, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316917941. Details of each certification follow.

Hospital certification: CCN 220033

Legal name
NORTHEAST HOSPITAL CORPORATION
Doing business as
BEVERLY HOSPITAL, ADDISON GILBERT HOSPITAL, BAY RIDGE HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 25, 2002
Beds
283
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1966 in MA
Enrollment address
85 Herrick St
Beverly, MA 19151790
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Northeast Hospital CorporationCCN 220033 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

17833 Colima Rd
City of Industry, CA 91748
Phone (626) 964-7764

218 W Badillo St
Covina, CA 91723
Phone (626) 332-6234

635 Anderson Rd
Ste 10
Davis, CA 95616
Phone (530) 758-1122

391 Front St
Ste F
Grover Beach, CA 93433
Phone (805) 219-6634

1050 Linden Ave
Fl 2
Long Beach, CA 90813
Phone (562) 491-9270

1127 Wilshire Blvd
Ste 909
Los Angeles, CA 90017
Phone (213) 320-3200

1640 W 3rd St
Los Angeles, CA 90017
Phone (213) 483-1251

1001 W Whittier Blvd
Ste B
Montebello, CA 90640
Phone (323) 728-8010

11865 Firestone Blvd
Norwalk, CA 90650
Phone (562) 806-1214

625 S Fair Oaks Ave
Ste 400
Pasadena, CA 91105
Phone (626) 568-1622

1135 S Sunset Ave
Ste 208
West Covina, CA 91790
Phone (626) 337-4425

100 Cummings Ctr
Ste 408J
Beverly, MA 01915
Phone (978) 524-9950

Ownership & related parties

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Paul Lundberg Individual Corporate Director Mar 1, 2019 100%
Cindy Rios Individual Corporate DirectorTreasurer Jan 1, 2023
Amy Thammalangsy Individual W-2 Managing EmployeeManager, Patient Accounts Aug 1, 2016
Tommy Lee Sands Individual Corporate Officer Apr 5, 2021 100%
Jamie Katz Individual Corporate OfficerClerk Mar 1, 2019 100%
Kevin M Tabb Individual Corporate OfficerCeo Mar 1, 2019 100%
Corporate DirectorCeo Mar 1, 2019 100%
Robert Irwin Individual Corporate Director Dec 19, 2012
Beth Israel Lahey Health, Inc. Organization, Cambridge, MA Non-profit 5% Or Greater Direct Ownership Interest Mar 1, 2019 100%
Mary C Boyd Individual Corporate DirectorTrustee Oct 1, 2019
Adrienne W Bradley Individual Corporate Director Mar 1, 2019 100%
Hugh M O'Flynn Individual Corporate Director Dec 19, 2012
Caroline Trujillo Individual Corporate DirectorTrustee Oct 1, 2020
Alexander Doumas Individual Corporate Director Dec 19, 2012
Michael T Rowan Individual Corporate DirectorTrustee Apr 1, 2021
Gregory Beaumier Individual Corporate OfficerCfo Jul 31, 2023
Corporate DirectorCfo Jul 31, 2023
Maryjane O'Neill Individual Corporate DirectorTrustee Oct 1, 2020
Christopher George Individual Corporate Director Dec 19, 2012
Karen Bell Individual Corporate DirectorTrustee Oct 1, 2019
Jeffrey Heit Individual Corporate DirectorTrustee Jul 1, 2022
Charles Furlong Individual Corporate Director Mar 1, 2019 100%
Hugh M Taylor Individual Corporate Officer Dec 19, 2012
Jonathan Payson Individual Corporate DirectorTrustee Oct 1, 2020
Bruce F Nardella Individual Corporate Director Mar 1, 2019 100%

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 18

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 18

Practitioners & affiliated clinicians

Practitioners 229

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 229

Affiliated clinicians 1,663

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,663

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472774400000",
    "number": "1316917941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "address_2": "BEVERLY HOSPITAL",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151776",
            "telephone_number": "978-922-3000",
            "fax_number": "978-921-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "address_2": "BEVERLY HOSPITAL",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151776",
            "telephone_number": "978-922-3000",
            "fax_number": "978-921-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2016-09-02",
        "status": "A",
        "authorized_official_last_name": "CORMIER",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "978-922-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "MA",
            "license": "V93D",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MA",
            "license": "15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000039",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC HMO/PHO INPAT",
            "identifier": "2222003301",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS PHO INPAT",
            "identifier": "901790",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "9343",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE INPAT",
            "identifier": "BEV2222003301",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "S005394",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC HMO/PHO OUTPAT",
            "identifier": "2222003311",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS MCR INPAT",
            "identifier": "901790",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007079",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC INDEM INPAT",
            "identifier": "2222003301",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST SENIORITY",
            "identifier": "900385",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1202626",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC INDEM OUTPAT",
            "identifier": "2222003311",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS MCR OUTPAT",
            "identifier": "900082",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000039",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS PHO OUTPAT",
            "identifier": "900082",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HMO",
            "identifier": "900385",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE OUTPAT",
            "identifier": "BEV2222003311",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Hospital Corporation",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.