NPIMap

Organization Active NPI

Dartmouth-Hitchcock Clinic

  • Family Medicine Physician
  • Manchester, NH
National Provider Identifier
1386697803
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DARTMOUTH-HITCHCOCK CLINIC
Practice address
100 Hitchcock Way
Manchester, NH 03104-4125
Phone
(603) 695-2500
NPI assigned
May 18, 2006
Last updated
May 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Authorized official

Name
Barbara E Moore
Title
Director,Billing Operations
Phone
(603) 653-2010

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 02552 NH
Radiology Clinic/Center 261QR0200X NU
Allergy & Immunology Physician 207K00000X NU
Dermatology Physician 207N00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU
Gastroenterology Physician 207RG0100X NU
Hematology & Oncology Physician 207RH0003X NU
Rheumatology Physician 207RR0500X NU
Obstetrics & Gynecology Physician 207V00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Otolaryngology Physician 207Y00000X NU
Pediatrics Physician 208000000X NU
Pediatric Cardiology Physician 2080P0202X NU

Addresses

Primary practice location

100 Hitchcock Way
Manchester, NH 03104-4125

Mailing address

PO Box 419100
Boston, MA 02241-9100

Other identifiers 17

IdentifierTypeStateIssuer
CA6501OtherNHRAILROAD
CN1486OtherNHRAILROAD MEDICARE
CC1439OtherNHRAILROAD MEDICARE
3080894MedicaidNH
CE1581OtherNHRAILROAD MEDICARE
DC7903OtherNHRAILROAD
3081001MedicaidNH
CA5651OtherNHRAILROAD MEDICARE
0000821MedicaidVT
CA0032OtherNHRAILROAD MEDICARE
CA5006OtherNHRAILROAD MEDICARE
DE5051OtherNHRAILROAD MEDICARE
3080411MedicaidNH
CA4893OtherNHRAILROAD MEDICARE
CA9427OtherNHRAILROAD MEDICARE
CB9189OtherNHRAILROAD MEDICARE
CN3827OtherNHRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20031111000313 NH Part B Supplier - Clinic/Group Practice 4183537509 Receives reassigned benefits from 258 practitioners
1 other NPI on this enrollment
Practice locations: Manchester, NH; Merrimack, NH; Milford, NH; Nashua, NH; Peterborough, NH; Walpole, NH; Winchester, NH; Dover, NH…
O20060328000430 VT Part B Supplier - Clinic/Group Practice 4183537509 Receives reassigned benefits from 2 practitioners
Practice locations: Brattleboro, VT
O20080114000625 NH Part B Supplier - Ambulatory Surgical Center 4183537509 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manchester, NH
O20120510000113 NH Part B Supplier - Ambulatory Surgical Center 4183537509 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Nashua, NH

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Dartmouth Hitchcock Ambulatory Surgery CenterCCN 30C0001014
Medicare certification status
ActiveFrom the Provider of Services file

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Dartmouth Hitchcock Nashua Endoscopy CenterCCN 30C0001031
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Foundation Med Partners19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

116 S River Rd
Unit A
Bedford, NH 03110
Phone (603) 641-8649

253 Pleasant St
Concord, NH 03301
Phone (603) 226-2200

Practitioners & affiliated clinicians

Practitioners 349

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 349

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1386697803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419100",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022419100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HITCHCOCK WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031044125",
            "telephone_number": "603-695-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARTMOUTH-HITCHCOCK CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR,BILLING OPERATIONS",
        "authorized_official_telephone_number": "603-653-2010"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NH",
            "license": "02552",
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "CA6501",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN1486",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC1439",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3080894",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CE1581",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "DC7903",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3081001",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA5651",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000821",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA0032",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA5006",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE5051",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3080411",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA4893",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA9427",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB9189",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN3827",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.