NPIMap

Organization Active NPI

Mascoma Community Healthcare Inc

  • Dental Clinic/Center
  • Canaan, NH
National Provider Identifier
1497298087
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MASCOMA COMMUNITY HEALTHCARE INC
Practice address
18 Roberts Road
Canaan, NH 03741
Phone
(603) 523-4501
NPI assigned
Nov 30, 2016
Last updated
Mar 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Authorized official

Name
Michael Samson
Title
Finance Manager
Phone
(603) 523-4501

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary
Dentist 122300000X NU
Public Health Dentistry 1223D0001X NU

Addresses

Primary practice location

18 Roberts Road
Canaan, NH 03741

Mailing address

PO Box 550
Canaan, NH 03741-0550
Phone (603) 523-4501

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170309000707 NH Part B Supplier - Clinic/Group Practice 2466736525 Receives reassigned benefits from 10 practitioners
Practice locations: Canaan, NH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1480464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1497298087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "CANAAN",
            "state": "NH",
            "postal_code": "037410550",
            "telephone_number": "603-523-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 ROBERTS ROAD",
            "city": "CANAAN",
            "state": "NH",
            "postal_code": "03741",
            "telephone_number": "603-523-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASCOMA COMMUNITY HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-30",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "SAMSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "FINANCE MANAGER",
        "authorized_official_telephone_number": "603-523-4501"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canaan, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; 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.