NPIMap

Organization Active NPI

Martha's Vineyard Hospital, Inc.

Doing business as Martha's Vineyard Hospital

  • Rural Health Clinic/Center
  • Oak Bluffs, MA
National Provider Identifier
1508413725
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MARTHA'S VINEYARD HOSPITAL, INC.
Doing business as
Martha's Vineyard Hospital
Practice address
1 Hospital Rd
Oak Bluffs, MA 02557-1406
Phone
(508) 693-0410
Fax
(508) 696-7746
NPI assigned
Aug 22, 2019
Last updated
Jan 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Authorized official

Name
Vincent T McDermott
Title
SVP, Chief Financial Officer
Phone
(617) 243-6381

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

1 Hospital Rd
Oak Bluffs, MA 02557-1406

Mailing address

PO Box 1477
Oak Bluffs, MA 02557-1477
Phone (508) 693-0410

Other names 1

  • Martha's Vineyard Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041220000589 MA Part B Supplier - Clinic/Group Practice 9931166113 Receives reassigned benefits from 269 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oak Bluffs, MA
O20200804001902 MA Part A Provider - Rural Health Clinic 9931166113 Practice locations: Oak Bluffs, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508413725. Details of each certification follow.

Rural health clinic certification: CCN 223981

Legal name
MARTHA'S VINEYARD HOSPITAL INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 26, 2021
Last certification
Mar 26, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Apr 1, 1921 in MA
Enrollment address
1 Hospital Rd
Oak Bluffs, MA 02557-1406
Related CCNs
221300

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Zachary Rosenburg Individual Corporate DirectorTrustee Mar 31, 2023
Thomas W Colomb Individual Corporate OfficerAssistant Secretary Jul 24, 2020
Debra a Burke Individual Corporate DirectorTrustee Jul 1, 2020
Daniel E Pesch Individual Corporate DirectorChief Medical Officer Jul 1, 2020
John M Denson Individual Corporate DirectorTrustee Nov 1, 2023
Joanna Hazell Individual Corporate DirectorDirector, Provider Enrollment Jan 1, 2024
W-2 Managing Employee Jan 1, 2024
Brent L Henry Individual Corporate DirectorTrustee Jul 1, 2020
Bruce Bullen Individual Corporate DirectorTrustee Jul 1, 2020
Paulo C Deoliveira Individual Corporate DirectorTrustee Jul 26, 2024
Denise Schepici Individual Corporate OfficerPresident Jul 1, 2020
Vincent T McDermott Individual Corporate DirectorCfo Jan 1, 2024
Robert M Greenglass Individual Corporate DirectorTrustee Jul 28, 2025
Christopher Scott Individual Corporate DirectorBoard of Directors Jul 1, 2020
Juliette E Fay Individual Corporate DirectorTrustee Jul 1, 2020
Peter Nessen Individual Corporate OfficerOfficer / Treasurer Jul 1, 2020
William J Roman Individual Corporate DirectorTrustee Jul 1, 2020
The Massachusetts General Hospital Organization, Boston, MA Corporation 5% Or Greater Direct Ownership Interest Feb 1, 2007 100%
Rebecca Haag Individual Corporate DirectorTrustee, Chair Sep 1, 2021
Valerie E Stone Individual Corporate DirectorTrustee, Vice Chair Jun 1, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 111

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.

View all 111

NPI Registry JSON

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1508413725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1477",
            "city": "OAK BLUFFS",
            "state": "MA",
            "postal_code": "025571477",
            "telephone_number": "508-693-0410",
            "fax_number": "508-696-7746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL RD",
            "city": "OAK BLUFFS",
            "state": "MA",
            "postal_code": "025571406",
            "telephone_number": "508-693-0410",
            "fax_number": "508-696-7746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA'S VINEYARD HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-22",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SVP, CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "617-243-6381"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Martha's Vineyard Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Martha's Vineyard Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Bluffs, MA

Sources for this page

Verify at the official NPI Registry.