NPIMap

Organization Active NPI

Nantucket Cottage Hospital

  • Rural Acute Care Hospital
  • Nantucket, MA
National Provider Identifier
1447214622
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
2044 Issued in MA
Legal business name
NANTUCKET COTTAGE HOSPITAL
Practice address
57 Prospect St
Nantucket, MA 02554-2799
Phone
(508) 825-8100
Fax
(508) 825-8101
NPI assigned
Apr 14, 2006
Last updated
Jul 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Authorized official

Name
Aaron Fishman
Title
VP Finance
Phone
(508) 825-8205

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 099 MA
Rural Acute Care Hospital 282NR1301X 2044 MA Primary

Addresses

Primary practice location

57 Prospect St
Nantucket, MA 02554-2799

Mailing address

57 Prospect St
Nantucket, MA 02554-2799
Phone (508) 825-8100

Other identifiers 8

IdentifierTypeStateIssuer
2222008101OtherMAHOSPITAL BXBS INPATIENT
1000527MedicaidMA
1001591MedicaidMA
1201301MedicaidMA
2222008110OtherMAHOSPITAL BXBS OUTPATIENT
1201310MedicaidMA
70010000120199OtherMACHHD - BXBS
900171OtherMAHOSPITAL HARVARD PILGRAM

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Nantucket Cottage Hospital

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050104000928 MA Part B Supplier - Clinic/Group Practice 1759357601 Receives reassigned benefits from 243 practitioners
1 other NPI on this enrollment
Practice locations: Nantucket, MA
O20070712000490 MA Part A Provider - Hospital 1759357601 Practice locations: Nantucket, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447214622. Details of each certification follow.

Hospital certification: CCN 220177

Legal name
NANTUCKET COTTAGE HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Feb 4, 2008
Last certification
Dec 21, 2007
Beds
19
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 20, 1911 in MA
Enrollment address
57 Prospect St
Nantucket, MA 25542799
Other Hospital Practice Location
Hospital subgroups
Acute care, Swing-bed approved

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

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 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Nantucket Cottage HospitalCCN 220177 · 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

Interoperability endpoints

  • Direct secure messaging: adams.annette.nch@direct.partners.masshiway.net
  • Direct secure messaging: aleknaite.ugne.nch@direct.partners.masshiway.net
  • Direct secure messaging: ali.nadeem.nch@direct.partners.masshiway.net
  • Direct secure messaging: andelloux.derek.nch@direct.partners.masshiway.net
  • Direct secure messaging: beer.stephanie.nch@direct.partners.masshiway.net
  • Direct secure messaging: black.cherylyn.nch@direct.partners.masshiway.net
  • Direct secure messaging: bolles.cynthia.nch@direct.partners.masshiway.net
  • Direct secure messaging: bowman.thomas.nch@direct.partners.masshiway.net
  • Direct secure messaging: carey.maria.nch@direct.partners.masshiway.net
  • Direct secure messaging: carroll.anne.nch@direct.partners.masshiway.net
  • Direct secure messaging: culkins.jayne.nch@direct.partners.masshiway.net
  • Direct secure messaging: dolan.deborah.nch@direct.partners.masshiway.net
  • Direct secure messaging: fassnacht.alison.nch@direct.partners.masshiway.net
  • Direct secure messaging: frable.faith.nch@direct.partners.masshiway.net
  • Direct secure messaging: gray.michael.nch@direct.partners.masshiway.net
  • Direct secure messaging: greenan.melanie.nch@direct.partners.masshiway.net
  • Direct secure messaging: harding.molly.nch@direct.partners.masshiway.net
  • Direct secure messaging: herrera.michele.nch@direct.partners.masshiway.net
  • Direct secure messaging: hynds-decoteau.rachael.nch@direct.partners.masshiway.net
  • Direct secure messaging: kaplan.caitlin.nch@direct.partners.masshiway.net

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
Derek a Andelloux Individual Corporate Director Sep 13, 2023
Jeanine M Borthwick Individual Corporate Director Aug 24, 2022
Melissa D Philbrick Individual Corporate Director Aug 16, 2019
Melanie R. Sabelhaus Individual Corporate Director Jul 29, 2016
Hillary Reynolds Individual Corporate Officer Aug 21, 2020
Timothy R Mullen Individual Corporate Director Aug 24, 2022
Craig H Muhlhauser Individual Corporate Officer Aug 16, 2019
Elizabeth B Wright Individual Corporate Director Aug 24, 2022
Jeffrey M Drazen Individual Corporate Director Aug 16, 2019
Ronald Levy Individual Corporate Director Aug 21, 2020
Joanna Hazell Individual Corporate Director Mar 16, 2021
Charles K Gifford Individual Corporate Director Apr 19, 2013
Elizabeth Tilney Individual Corporate Director Jan 1, 2024
Matthew Hutter Individual Corporate Director Jan 19, 2024
Gerard Joseph Keneally Individual Corporate Officer Jul 21, 2023
Douglass E Karp Individual Corporate Director Jun 1, 2024
David O Volpi Individual Corporate Director Aug 16, 2019
Nancy S Pittman Individual Corporate OfficerVP of Policy Admin. and Contracting Aug 21, 2020
W-2 Managing Employee Jan 5, 2016
Vincent T McDermott Individual Corporate Officer Mar 24, 2023
Anne Klibanski Individual Corporate DirectorInterim President and Ceo May 1, 2019
Elisabeth JM Schadae Percelay Individual Corporate Director Oct 21, 2016
Mass General Brigham Incorporated Organization, Somerville, MA Corporation, Non-profit Operational/Managerial Control Feb 1, 2007 100%
Amy Lee Individual Corporate OfficerPresident Oct 17, 2022
Heather Mahoney O'Sullivan Individual Corporate Director Mar 3, 2023
Jeannette Ives Erickson Individual Corporate Director Oct 17, 2022

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Nantucket Cottage Medical GroupNantucket, MA, CCN 223979 Rural health clinic Operational/Managerial Control (100%) Jul 16, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 258

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 258

Affiliated clinicians 199

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

View all 199

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1447214622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 PROSPECT ST",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025542799",
            "telephone_number": "508-825-8100",
            "fax_number": "508-825-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 PROSPECT ST",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025542799",
            "telephone_number": "508-825-8100",
            "fax_number": "508-825-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANTUCKET COTTAGE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "FISHMAN",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "508-825-8205"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MA",
            "license": "099",
            "primary": false
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "MA",
            "license": "2044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL BXBS INPATIENT",
            "identifier": "2222008101",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000527",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001591",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1201301",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL BXBS OUTPATIENT",
            "identifier": "2222008110",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1201310",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHHD - BXBS",
            "identifier": "70010000120199",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL HARVARD PILGRAM",
            "identifier": "900171",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Nantucket Cottage Hospital",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nantucket, MA

Sources for this page

Verify at the official NPI Registry.