Hyde Park Health Associates Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

73981 Issued in MA

Legal business name

HYDE PARK HEALTH ASSOCIATES INC.

Practice address

745 River St
Mattapan, MA 02126-1941

Phone

(617) 364-2588

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Clifford Bonnet

Title

Office Manager

Phone

(401) 954-2351

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jean S.F. Bonnet, M.D.

  • Internal Medicine Physician
  • Mattapan, MA
  • NPI 1164583787
  Medicare reassignment NPD

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1467543710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 RIVER ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021261941",
            "telephone_number": "617-364-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 RIVER ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021261941",
            "telephone_number": "617-364-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK HEALTH ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "BONNET",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "401-954-2351"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MA",
            "license": "73981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "73981",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Sharoun Howard, RN
• Minh Tam Hua, PHARMD
• Maxi F Hudson, MS
• Christopher R Hutchison-Jones, LICSW
• Hyde Park Choice Chiropractic Inc
• Courtney E Iftiger, DPT
• Promise Uchegbulam Igbokwe, CLINICIAN
• J&M Exceptional Care
• Michelle A Jack, RN
• Sharon Denise Jackson, MS RD CDE

• Primary Care Clinic/Center in Mattapan, MA
• Providers in Mattapan, MA by specialty
• Primary Care Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.