NPIMap

Organization Active NPI

Manet Community Health Center, Inc.

Doing business as Manet Community Health Center at Fr. Bills

  • Federally Qualified Health Center (FQHC)
  • Quincy, MA
National Provider Identifier
1427795681
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MANET COMMUNITY HEALTH CENTER, INC.
Doing business as
Manet Community Health Center at Fr. Bills
Practice address
39 Broad St
Quincy, MA 02169-4689
Phone
(617) 376-3000
NPI assigned
May 18, 2022
Last updated
Mar 3, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MANET COMMUNITY HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Authorized official

Name
Cynthia Sierra
Title
Chief Executive Officer
Phone
(617) 404-4101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

39 Broad St
Quincy, MA 02169-4689

Mailing address

110 W Squantum St Ste 8
Quincy, MA 02171-2158
Phone (617) 404-4102

Other names 1

  • Manet Community Health Center at Fr. Bills Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240618002385 MA Part A Provider - Federally Qualified Health Center (FQHC) 4486555158 Practice locations: Quincy, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427795681. Details of each certification follow.

Federally qualified health center certification: CCN 221008

Legal name
MANET COMMUNITY HEALTH CENTER, INC.
Doing business as
MANET COMMUNITY HEALTH CENTER AT FR. BILLS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 14, 2024
Last certification
Jun 14, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 5, 1978 in MA
Enrollment address
39 Broad St
Quincy, MA 21694689

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Manet Community Health Center Inc13 organizations share this tax ID, including this one
Part of
Manet Community Health Center Inc

Other organizations with this tax ID 12

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

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Cynthia Sierra Individual Corporate OfficerChief Executive Officer Jan 15, 2016 100%
Samantha Chen Individual Corporate DirectorBoard Member Jan 15, 2019 100%
Zachary Eaton Individual Corporate DirectorBoard Member Dec 16, 2014 100%
Neda Hovaizi Individual Corporate DirectorBoard Member Jan 15, 2019 100%
Lawrence Flanagan Individual Corporate DirectorBoard Member Feb 21, 2017 100%
John D Brothers Individual Corporate DirectorBoard Member Dec 5, 2000 100%
Joseph M Reardon Individual Corporate DirectorBoard Member May 1, 2007 100%
Robert Griffin Individual Corporate DirectorBoard Member Jan 24, 2011 100%
Jane Kisielius Individual Corporate DirectorBoard Member Dec 17, 2017 100%
Grace McAuliffe Individual Corporate DirectorBoard Member Dec 17, 2017 100%
Anita Christie Individual Corporate DirectorBoard Member Dec 17, 2017 100%
Ivan S Wong Individual Corporate DirectorBoard Member Oct 20, 2009 100%
Linda a Kelly Individual Corporate DirectorBoard Member May 6, 2006 100%
Karen Ward Individual Corporate DirectorBoard Member Dec 17, 2017 100%
Roberto Costa Individual Corporate DirectorBoard Member Dec 17, 2017 100%
Tara Major Individual Corporate DirectorBoard Member Jan 2, 2024 80%
Nancy Wyrebek Individual Corporate DirectorBoard Member Dec 17, 2017 100%
Cathy Liu Individual W-2 Managing EmployeeManager Feb 2, 2024 20%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1427795681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W SQUANTUM ST STE 8",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021712158",
            "telephone_number": "617-404-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 BROAD ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694689",
            "telephone_number": "617-376-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANET COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MANET COMMUNITY HEALTH CENTER, INC.",
        "enumeration_date": "2022-05-18",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "SIERRA",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-404-4101"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manet Community Health Center at Fr. Bills",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Manet Community Health Center at Fr. Bills",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.