NPIMap

Organization Active NPI

Northeast Hospital Corporation

Doing business as Center for Healthy Aging

  • Critical Access Hospital
  • Danvers, MA
National Provider Identifier
1508052218
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
225012 Issued in MA
Legal business name
NORTHEAST HOSPITAL CORPORATION
Doing business as
Center for Healthy Aging
Practice address
480 Maple St
Center for Healthy Aging
Danvers, MA 01923-4065
Phone
(978) 646-7070
Fax
(978) 921-7048
NPI assigned
Sep 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Authorized official

Name
Mr. Denis S. Conroy
Title
Ceo
Phone
(978) 922-3000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 225012 MA Primary
Critical Access Hospital 282NC0060X

Addresses

Primary practice location

480 Maple St
Center for Healthy Aging
Danvers, MA 01923-4065

Mailing address

85 Herrick Street
Medical Staff Office
Beverly, MA 01915
Phone (978) 922-3000

Other names 1

  • Center for Healthy Aging Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420001051 MA Part B Supplier - Clinic/Group Practice 1153213202 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Danvers, MA

Other NPIs with the same Medicare PAC ID 2

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.

National Provider Directory

National Provider Directory
Tax ID family
Northeast Hospital Corp11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

480 Maple St
#201
Danvers, MA 01923
Phone (978) 646-7070

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1508052218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HERRICK STREET",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-922-3000",
            "fax_number": "978-921-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MAPLE ST",
            "address_2": "CENTER FOR HEALTHY AGING",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019234065",
            "telephone_number": "978-646-7070",
            "fax_number": "978-921-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "CONROY",
        "authorized_official_first_name": "DENIS",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "978-922-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MA",
            "license": "225012",
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Healthy Aging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.