NPIMap

Organization Active NPI

Harbor Health Services, Inc.

Doing business as Harbor Community Health Center-Hyannis

  • Community Health Clinic/Center
  • Hyannis, MA
National Provider Identifier
1376502070
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
HARBOR HEALTH SERVICES, INC.
Doing business as
Harbor Community Health Center-Hyannis
Practice address
735 Attucks LN
Hyannis, MA 02601-1867
Phone
(508) 778-0300
Fax
(508) 778-8747
NPI assigned
Mar 21, 2006
Last updated
Jul 8, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
HARBOR HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

Name
Mr. Charles T. Jones
Title
President & Ceo
Phone
(617) 533-2300

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Community Health Clinic/Center 261QC1500X MA Primary
Federally Qualified Health Center (FQHC) 261QF0400X

Addresses

Primary practice location

735 Attucks LN
Hyannis, MA 02601-1867

Mailing address

1135 Morton Street
Mattapan, MA 02126-2834
Phone (617) 533-2300

Other identifiers 2

IdentifierTypeStateIssuer
110027821AMedicaidMA
1301225MedicaidMA

Other names 1

  • Harbor Community Health Center-Hyannis Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031210001049 MA Part A Provider - Federally Qualified Health Center (FQHC) 0345146213 Practice locations: Hyannis, MA
O20040223000221 MA Part B Supplier - Clinic/Group Practice 0345146213 Receives reassigned benefits from 76 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hyannis, MA; South Dennis, MA; Plymouth, MA; Mattapan, MA; Dorchester, MA
O20050324000106 MA Part B Supplier - Clinic/Group Practice 0345146213 Receives reassigned benefits from 23 practitioners
Practice locations: Hyannis, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376502070. Details of each certification follow.

Federally qualified health center certification: CCN 221850

Legal name
HARBOR HEALTH SERVICES INC
Doing business as
HARBOR COMMUNITY HEALTH CENTER-HYANNIS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 15, 2003
Last certification
Dec 15, 2003
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 24, 1970 in MA
Enrollment address
735 Attucks LN
Hyannis, MA 26011867

Other NPIs with the same Medicare PAC ID 3

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

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
Neponset Health Center18 organizations share this tax ID, including this one
Part of
Neponset Health Center

Other organizations with this tax ID 17

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

View all 17

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Joe Greene Individual Corporate Director Dec 1, 2022
John Ohara Individual Corporate Director Dec 1, 2022
Maura Doyle Individual Corporate DirectorBoard Member Jan 2, 2013
Annie Le Individual Corporate DirectorBoard Member Dec 1, 2021
Mike Mecenas Individual Corporate DirectorBoard Member Mar 1, 2023
Trinh Nguyen Individual Corporate Director Dec 1, 2021
Jan a Mattimoe Individual Corporate DirectorBoard Member Dec 1, 1996
Queenette Santos Individual Corporate DirectorBoard Member Feb 16, 2003
Kristopher Todd Murphy Individual Corporate Director Dec 4, 2017
W-2 Managing Employee Dec 4, 2017
Patrick Preston Individual Corporate DirectorBoard Member Jul 1, 2020
Kush Badshah Individual Corporate Director Dec 1, 2021
Leon David Individual Corporate Director Mar 1, 2016

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1376502070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 MORTON STREET",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262834",
            "telephone_number": "617-533-2300",
            "fax_number": "617-533-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 ATTUCKS LN",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026011867",
            "telephone_number": "508-778-0300",
            "fax_number": "508-778-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HARBOR HEALTH SERVICES, INC.",
        "enumeration_date": "2006-03-21",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "617-533-2300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "MA",
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110027821A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1301225",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harbor Community Health Center-Hyannis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hyannis, MA

Sources for this page

Verify at the official NPI Registry.