South Shore Hospital Inc.
Organization Active NPI Home Health Agency · Braintree, MA
NPI 1669558474 · NPPES record last updated Dec 28, 2021
Key facts
- NPI
- 1669558474
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- SOUTH SHORE HOSPITAL INC.
- Practice address
- 100 Bay State Drive
Braintree, MA 02184-9060 - Phone
- (781) 849-1710
- NPI assigned
- Oct 27, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTH SHORE HOSPITAL INC.
Authorized official
- Name
- Richard Edward Pascarelli
- Title
- Finance Manager
- Phone
- (781) 624-7891
Owners & managing parties with NPI records 2
-
Amanda Marchica, DO
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 3
Affiliated clinicians 230
-
Leslie-Ann Alexander, M.D.
-
Khalil Alleyne, MD
-
Margaret T Anastasi, ANP
-
Erin M Anderson, PA
-
Elvis Joel Aponte-Rivera, M.D.
-
Michael E Ayers, M.D.
-
Mirza Baig, MD
-
Jennifer Esler Bastis, PA-C
-
Aoife Bennette, FNP-C
-
Dyan Bhatia, M.D.
-
Richard Black, MD
-
Jean Borelli, MD
-
Daniel Edward Borezo, PA-C
-
Debra A Bradford, NP
-
Arthur Ralph Bregoli Jr., M.D.
-
Kevin J Broderick, D.O.
-
Denise R Brown, MD
-
Margaret R Brown, ANP-BC
-
Shannon Leigh Burnham, M.D.
Medicare Care Compare: Home health agency
- Listed as
- South Shore Visiting Nurse Association
- Overall star rating
- ★★★☆☆ 3 of 5
- Ownership
- Non-Profit
- Certified
- Jul 1, 1966
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D0890716 | South Shore Hospital Vna & Home Health | Certificate of waiver | Oct 1, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Home health agency certification: CCN 227082A
- Legal name
- SOUTH SHORE HOSPITAL INC.
- Doing business as
- SOUTH SHORE VNA
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 18, 1987 in MA
- Enrollment address
- 30 Reservoir Park Dr
Rockland, MA 02370-1055
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| Michael Sheehan |
Corporate Director | Feb 1, 2024 | |
| Ellen Essenfeld |
Corporate Director | Feb 1, 2024 | |
| Paul Watanabe |
Corporate Director | Feb 1, 2024 | |
| Alan McKim |
Corporate Director | Feb 1, 2024 | |
| Amanda R Marchica |
Corporate Director | Feb 1, 2024 | |
| Thomas McCarthy |
Corporate Director | Feb 1, 2024 | |
| Pamela O'Leary |
Corporate Director | Feb 1, 2024 | |
| Allen L Smith |
Corporate Director | Feb 1, 2024 | |
| Paula Becker |
Corporate Director | Feb 1, 2024 | |
| Joseph Driscoll |
Corporate Director | Feb 1, 2024 | |
| Kimberly O Dever |
Corporate Director | Feb 1, 2024 | |
| Christopher Ducko |
Corporate Director | Feb 1, 2024 | |
| Stephen Jenney |
Corporate Officer |
Jan 1, 2025 | |
| Pamela D Whelton |
Corporate Director | Feb 1, 2024 | |
| Grace Lee |
Corporate Director | Feb 1, 2024 | |
| Helen Garvey |
Corporate Director | Feb 1, 2024 | |
| Kenneth Quigley |
Corporate Director | Feb 1, 2024 | |
| Richard Pascarelli |
W-2 Managing Employee | Feb 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060508000698 | MA | Part a Provider - Home Health Agency | 4385546217 | Practice locations: Rockland, MA |
National Provider Directory
- Tax ID family
- South Shore Hospital in
- Part of
- South Shore Hospital in
Locations
30 Reservoir Park Dr
Rockland, MA 02370
Phone (781) 624-7070
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
100 Bay State Drive
Braintree, MA 02184-9060
Mailing address
30 Reservoir Park Dr
Rockland, MA 02370-1055
Phone (781) 617-7891
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000021549 | Other | BOSTON MEDICAL CTR HLTH N | |
| 0605875 | Other | COMMISSION OF THE BLIND | |
| 0605875 | Medicaid | MA | |
| 702005 | Other | HARVARD PILGRIM HLTH CARE | |
| 803015 | Other | TUFTS HEALTH PLAN | |
| 120082 | Other | BLUE CROSS BLUE SHIELD | |
| 0009286 | Other | NEIGHBORHOOD HEALTH | |
| 1339 | Other | CIGNA |
Other names
- South Shore Visiting Nurse Association
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Other providers in Braintree, MA
- South Shore Elder Services Inc
- South Shore Endoscopy Center, Inc
- South Shore Health Care, Inc.
- South Shore Health Express, Inc
- South Shore Hospital
- South Shore Hospital Inc.
- South Shore Physiatry and Spasticity Management
- South Shore Skin Surgeons Bi LLC
- South Shore Skin Surgeons, PC
- South Shore Therapy and Associates
All providers in Braintree, MA · Home Health Agency in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.