NPIMap

Organization Active NPI

North End Community Health Committee Inc

Doing business as North End Community Health Center

  • Public Health & General Preventive Medicine Physician
  • Boston, MA
National Provider Identifier
1780606608
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
4143 Issued in MA
Legal business name
NORTH END COMMUNITY HEALTH COMMITTEE INC
Doing business as
North End Community Health Center
Practice address
332 Hanover Street
Boston, MA 02113
Phone
(617) 643-8000
Fax
(617) 643-8127
NPI assigned
Jul 24, 2006
Last updated
Jun 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Authorized official

Name
Mr. Vincenzo ScibelliNPI 1770500712
Title
Chief Executive Officer
Phone
(617) 643-8082

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 4143 MA Primary

Addresses

Primary practice location

332 Hanover Street
Boston, MA 02113

Mailing address

332 Hanover Street
Boston, MA 02113
Phone (617) 643-8000

Other identifiers 1

IdentifierTypeStateIssuer
1300253MedicaidMA

Other names 1

  • North End Community Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060216000209 MA Part B Supplier - Clinic/Group Practice 8224043971 Receives reassigned benefits from 76 practitioners
Practice locations: Boston, MA; Charlestown, MA
O20101215000410 MA Part A Provider - Federally Qualified Health Center (FQHC) 8224043971 Practice locations: Boston, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780606608. Details of each certification follow.

Federally qualified health center certification: CCN 221812

Legal name
NORTH END COMMUNITY HEALTH COMMITTEE, INC.
Doing business as
NORTH END WATERFRONT HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 1992
Last certification
Jan 1, 1992
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jun 23, 1970 in MA
Enrollment address
332 Hanover St
Boston, MA 21131901

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Meredith K Stewart Individual Corporate DirectorBoard Member Oct 1, 2010
Jonathan Sproul Individual Corporate DirectorBoard Member Oct 1, 2010
Norma Repucci Individual Corporate DirectorBoard Member Jun 1, 1981
Vincenzo a Scibelli Individual Corporate OfficerCoo Jun 1, 2009
W-2 Managing Employee Nov 1, 2012
Bethany Daily Individual Corporate DirectorBoard Member Nov 1, 2012
Marilyn D. Stempler Individual Corporate DirectorBoard Member Apr 1, 2008
Denise Clancy Individual Corporate DirectorBoard Member Jul 1, 2003
James Luisi Individual Corporate OfficerCeo Jul 1, 1988
W-2 Managing Employee Jul 1, 1988
Daniel Leonard Individual Corporate OfficerCeo Feb 9, 1998
Corporate Director Feb 9, 1998
W-2 Managing Employee Oct 1, 2010
Britain Walton Nicholson Individual Corporate DirectorBoard Member Jul 1, 2000
Elaine Wilson Individual Corporate DirectorBoard Member Apr 1, 1988
Nancy Sullivan Individual Corporate DirectorBoard Member Oct 1, 2010
Andrea Evans Individual Corporate DirectorBoard Member Nov 1, 2012
Michael Primo Individual Corporate DirectorBoard Member Nov 1, 2011
Sally Iles Individual Corporate DirectorBoard Member Jul 1, 2000
John a Foster Individual Corporate Officer Jul 1, 1988
W-2 Managing Employee Jul 1, 1988

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 83

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 83

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656288000000",
    "number": "1780606608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 HANOVER STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02113",
            "telephone_number": "617-643-8000",
            "fax_number": "617-643-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 HANOVER STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02113",
            "telephone_number": "617-643-8000",
            "fax_number": "617-643-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH END COMMUNITY HEALTH COMMITTEE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A",
        "authorized_official_last_name": "SCIBELLI",
        "authorized_official_first_name": "VINCENZO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-643-8082",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "MA",
            "license": "4143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1300253",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North End Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North End Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.