Active NPI
Old Colony YMCA Wellness Services, Inc.
- Health Educator
- Brockton, MA
National Provider Identifier
1497385314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Legal business name
- OLD COLONY YMCA WELLNESS SERVICES, INC.
- Practice address
- 320 Main St
Brockton, MA 02301-5340 - Phone
- (508) 583-2155
- NPI assigned
- Jan 20, 2020
- Last updated
- Oct 16, 2024
- Organization subpart
- Yes
- Parent organization
- OLD COLONY YMCA
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Vincent Marturano, MSW, ACSW
- Title
- President and Ceo
- Phone
- (508) 427-4358
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | Primary |
Addresses
Primary practice location
320 Main St
Brockton, MA 02301-5340
Mailing address
320 Main St
Brockton, MA 02301-5340
Phone (508) 583-2155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210917001268 | MA | MDPP Supplier - in-Person MDPP Supplier | 4880091891 | Practice locations: Brockton, MA |
National Provider Directory
National Provider Directory- Tax ID family
- Old Colony YMCA Wellness Services Inc
- Part of
- Old Colony Y
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Public Health or Welfare Agency
- Stoughton, MA
- NPI 1497574206
-
- Case Management Agency
- Stoughton, MA
- NPI 1598587149
Locations
25 Elm St
North Easton, MA 02356
Phone (508) 238-9758
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579478400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1729036800000",
"number": "1497385314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 MAIN ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023015340",
"telephone_number": "508-583-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 MAIN ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023015340",
"telephone_number": "508-583-2155"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OLD COLONY YMCA WELLNESS SERVICES, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "OLD COLONY YMCA",
"enumeration_date": "2020-01-20",
"last_updated": "2024-10-16",
"certification_date": "2024-10-16",
"status": "A",
"authorized_official_last_name": "MARTURANO",
"authorized_official_first_name": "VINCENT",
"authorized_official_title_or_position": "PRESIDENT AND CEO",
"authorized_official_telephone_number": "508-427-4358",
"authorized_official_credential": "MSW, ACSW"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
- Chinonye Okeke
- Obioma Linda Okeke
- Old Colony Elderly Services, Inc.
- Old Colony Elderly Services, Inc.
- Old Colony Elderly Services, Inc.
- Old Colony Young Men's Christian Association, Inc. (Old Colony Y Comprehensive Counseling)
- Pamela Oldenburg, MAED
- Janis Oliveira, LCSW
- Jernice Andrade Oliveira I, MASSAGE THERAPIST
- Susan Oliveira, CRNA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.