NPIMap

Organization Active NPI

New England Baptist Hospital

  • General Acute Care Hospital
  • Roxbury Crossing, MA
National Provider Identifier
1699767491
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
2059 Issued in MA
Legal business name
NEW ENGLAND BAPTIST HOSPITAL
Practice address
125 Parker Hill Ave
Roxbury Crossing, MA 02120-2847
Phone
(617) 754-5800
Fax
(617) 754-6418
NPI assigned
Aug 17, 2005
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
David A Passafaro
Title
President
Phone
(617) 754-5001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 2059 MA Primary

Addresses

Primary practice location

125 Parker Hill Ave
Roxbury Crossing, MA 02120-2847

Mailing address

125 Parker Hill Ave
Roxbury Crossing, MA 02120-2847
Phone (617) 754-5800

Other identifiers 10

IdentifierTypeStateIssuer
1000543MedicaidMA
903897OtherMATUFTS INPATIENT
NEW2222008810OtherMABLUE CROSS OUTPATIENT
900033OtherMATUFTS OUTPATIENT
900073OtherMAHARVARD PILGRIM INPT/OUTP
NEW2222008830OtherMABLUE CROSS DAY SURGERY
728263OtherMDTUFTS SNF
NEW2222556301OtherMABLUE CROSS SNF
1201336MedicaidMA
NEW2222008801OtherMABLUE CROSS INPATIENT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040628000562 MA Part A Provider - Hospital 3375529670 Practice locations: Dedham, MA; Brookline, MA; Boston, MA; Chestnut Hill, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699767491. Details of each certification follow.

Hospital certification: CCN 220088

Legal name
NEW ENGLAND BAPTIST HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Dec 15, 2016
Beds
118
Ownership / control type
Private (not for profit)
Most recent change of ownership
Oct 1, 1996 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Sep 19, 1893 in MA
Enrollment address
125 Parker Hill Ave
Boston, MA 21202847
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Specialty hospital

Care Compare: Hospital

Medicare Care Compare
Listed as
New England Baptist HospitalCCN 220088 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Member organizations 4

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

Locations

830 Boylston St
Chestnut Hill, MA 02467
Phone (617) 739-2003

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
John Bachman Individual Corporate Director Mar 1, 2019
Brian L Hollenbeck Individual Corporate Officer Oct 5, 2020
W-2 Managing Employee Aug 29, 2021
Colleen Kigin Individual Corporate DirectorBoard Member Oct 1, 2023
Roberto a Cruz-Gervis Individual Corporate Director Dec 1, 2021
W-2 Managing Employee Jul 14, 2004
Beth Israel Lahey Health, Inc. Organization, Boston, MA Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Mar 1, 2019 100%
Judene Williams Individual Corporate DirectorBoard Member Oct 1, 2023
Nancy Nager Individual Corporate Director Dec 11, 2019
David a Mattingly Individual Corporate Officer Mar 1, 2019
Corporate Director Mar 1, 2019
Christopher Collins Individual Corporate Director Mar 1, 2019
Joseph Albanese Individual Corporate DirectorBoard Member Oct 1, 2023
Frederick C Basilico Individual Corporate Director Mar 1, 2019
Brian Smith Individual Corporate Officer Aug 21, 2023
Thomas Barker Individual Corporate Director Sep 18, 2019
Michael T Rowan Individual Corporate Director Jul 1, 2021
Gregory Cahill Individual Corporate Director Dec 11, 2019
John Jackson Individual Corporate Director Jul 21, 2021
Mary Sullivan Smith Individual Corporate Director Mar 1, 2019
W-2 Managing Employee Mar 1, 2019
David Passafaro Individual Corporate Director Mar 1, 2019
W-2 Managing EmployeePresident Mar 1, 2019

Owners & managing parties with NPI records 4

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

Facilities with the same owner 18

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

View all 18

Practitioners & affiliated clinicians

Practitioners 18

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 18

Affiliated clinicians 348

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 348

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1699767491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PARKER HILL AVE",
            "city": "ROXBURY CROSSING",
            "state": "MA",
            "postal_code": "021202847",
            "telephone_number": "617-754-5800",
            "fax_number": "617-754-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PARKER HILL AVE",
            "city": "ROXBURY CROSSING",
            "state": "MA",
            "postal_code": "021202847",
            "telephone_number": "617-754-5800",
            "fax_number": "617-754-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ENGLAND BAPTIST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-17",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "PASSAFARO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-754-5001"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MA",
            "license": "2059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000543",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS INPATIENT",
            "identifier": "903897",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OUTPATIENT",
            "identifier": "NEW2222008810",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS OUTPATIENT",
            "identifier": "900033",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM INPT/OUTP",
            "identifier": "900073",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS DAY SURGERY",
            "identifier": "NEW2222008830",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS SNF",
            "identifier": "728263",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SNF",
            "identifier": "NEW2222556301",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1201336",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS INPATIENT",
            "identifier": "NEW2222008801",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury Crossing, MA

Sources for this page

Verify at the official NPI Registry.