NPIMap

Organization Active NPI

Pine Street Inn

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Boston, MA
National Provider Identifier
1649658741
Registry record updated May 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X
License
220519 Issued in MA
Legal business name
PINE STREET INN
Practice address
170 Morton St
Boston, MA 02130-3735
Phone
(617) 892-7893
NPI assigned
May 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2015

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

Authorized official

Name
Ms. Maria Imelda Fitzpatrick, LCSW
Title
Clinician
Phone
(617) 892-7893

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X 220519 MA Primary

Addresses

Primary practice location

170 Morton St
Boston, MA 02130-3735

Mailing address

1220 Adams St
G17
Boston, MA 02124-5752
Phone (917) 334-2916

National Provider Directory

National Provider Directory
Tax ID family
Pine Street Inn4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/pinestreetinn/r4/

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1649658741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 ADAMS ST",
            "address_2": "G17",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021245752",
            "telephone_number": "917-334-2916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MORTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-892-7893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE STREET INN",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "FITZPATRICK",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "IMELDA",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "617-892-7893",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "MA",
            "license": "220519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.