NPIMap

Organization Active NPI

Wentworth Douglass Hospital

  • Oncology Clinic/Center
  • Portsmouth, NH
National Provider Identifier
1477038461
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology Clinic/CenterTaxonomy code 261QX0200X
Legal business name
WENTWORTH DOUGLASS HOSPITAL
Practice address
121 Corporate Dr BLDG a
Portsmouth, NH 03801-6895
Phone
(603) 742-8787
NPI assigned
Sep 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Authorized official

Name
Joel Degenaars
Title
Executive Director of Finance
Phone
(603) 740-2806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Clinic/Center 261QX0200X Primary

Addresses

Primary practice location

121 Corporate Dr BLDG a
Portsmouth, NH 03801-6895

Mailing address

PO Box 412540
Boston, MA 02241-2540

Other identifiers 1

IdentifierTypeStateIssuer
3074430MedicaidNH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040730000120 NH Part B Supplier - Clinic/Group Practice 9234047762 Receives reassigned benefits from 4 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dover, NH; Somersworth, NH; Rochester, NH; Portsmouth, NH; Lee, NH; Durham, NH

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory
Tax ID family
Scott J Low DO17 organizations share this tax ID, including this one
Part of
Scott J Low DO

Other organizations with this tax ID 16

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

View all 16

Locations

121 Corporate Dr
Bldg A
Portsmouth, NH 03801
Phone (603) 742-8787

121 Corporate Dr
Portsmouth, NH 03801
Phone (603) 740-5252

NPI Registry JSON

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1477038461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412540",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CORPORATE DR BLDG A",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038016895",
            "telephone_number": "603-742-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENTWORTH DOUGLASS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-26",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "DEGENAARS",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "603-740-2806"
    },
    "taxonomies": [
        {
            "code": "261QX0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3074430",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; 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.