Organization Active NPI

Greater Boston Chinese Golden Age Center, Inc.

  • Case Management Agency
  • Boston, MA
National Provider Identifier
1417139239
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
1533193 Issued in MA
Legal business name
GREATER BOSTON CHINESE GOLDEN AGE CENTER, INC.
Practice address
75 Kneeland St
Suite 204
Boston, MA 02111-1901
Phone
(617) 357-0226
Fax
(617) 357-4323
NPI assigned
Dec 4, 2007
Last updated
Dec 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Ms. Ruth C. Moy
Title
Executive Director
Phone
(617) 357-0226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 1533193 MA Primary

Addresses

Primary practice location

75 Kneeland St
Suite 204
Boston, MA 02111-1901

Mailing address

75 Kneeland St
Suite 204
Boston, MA 02111-1901
Phone (617) 357-0226

Other identifiers 1

IdentifierTypeStateIssuer
1533193MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241010001097 MA Part B Supplier - Clinic/Group Practice 1153853585 Receives reassigned benefits from 1 practitioner
Practice locations: Boston, MA

National Provider Directory

National Provider Directory
Tax ID family
Greater Boston Chinese Golden Age Center Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

75 Kneeland St
Ste 204
Boston, MA 02111
Phone (617) 357-0226

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1417139239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 KNEELAND ST",
            "address_2": "SUITE 204",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111901",
            "telephone_number": "617-357-0226",
            "fax_number": "617-357-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 KNEELAND ST",
            "address_2": "SUITE 204",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111901",
            "telephone_number": "617-357-0226",
            "fax_number": "617-357-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER BOSTON CHINESE GOLDEN AGE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "MOY",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "617-357-0226",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MA",
            "license": "1533193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1533193",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.