NPIMap

Organization Active NPI

Umass Memorial Health-Harrington Hospital Inc

  • General Acute Care Hospital
  • Southbridge, MA
National Provider Identifier
1790780047
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
57 Issued in MA
Legal business name
UMASS MEMORIAL HEALTH-HARRINGTON HOSPITAL INC
Practice address
100 South Street
Southbridge, MA 01550
Phone
(508) 765-9771
Fax
(508) 764-2490
NPI assigned
Jun 14, 2005
Last updated
Dec 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Authorized official

Name
John E Bronhard II
Title
Cfo
Phone
(617) 224-7634

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 57 MA Primary

Addresses

Primary practice location

100 South Street
Southbridge, MA 01550

Mailing address

100 South Street
Southbridge, MA 01550
Phone (508) 765-9771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA3 enrollments
Opioid treatment program
Medicare-enrolled since Nov 3, 2021

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20041004001081 MA Part B Supplier - Clinic/Group Practice 8123087319 Receives reassigned benefits from 74 practitioners
Practice locations: Webster, MA; Sturbridge, MA; Spencer, MA; Southbridge, MA; Charlton, MA; East Brookfield, MA
O20071228000134 MA Part A Provider - Hospital 8123087319 Practice locations: Charlton, MA; Webster, MA; Sturbridge, MA; Spencer, MA; Southbridge, MA
O20220131000171 MA Part A Provider - Other 8123087319 Practice locations: Webster, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790780047. Details of each certification follow.

Hospital certification: CCN 220019

Legal name
UMASS MEMORIAL HEALTH-HARRINGTON HOSPITAL INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 23, 1993
Beds
113
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
100 South St
Southbridge, MA 15504051
Main/Primary Hospital Location
Hospital subgroups
Acute care, Psychiatric unit

Care Compare: Hospital

Medicare Care Compare
Listed as
Umass Memorial Health - Harrington HospitalCCN 220019 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 1

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

Locations

20 Southbridge Rd
Charlton, MA 01507
Phone (508) 248-4141

100 South St
Ste 103
Southbridge, MA 01550
Phone (508) 764-2515

100 South St
Ste 110
Southbridge, MA 01550
Phone (508) 764-8012

32 Oakes Ave
Southbridge, MA 01550
Phone (508) 765-3093

55 Sayles St
Southbridge, MA 01550
Phone (508) 764-2400

94 South St
Fl 2
Southbridge, MA 01550

118 Main St
Ste 3
Sturbridge, MA 01566
Phone (215) 380-4861

198 Charlton Rd
Ste 1
Sturbridge, MA 01566

336 Thompson Rd
Webster, MA 01570
Phone (508) 943-0382

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Sergio L Melgar Individual Corporate OfficerTreasurer Mar 31, 2014
Corporate Director Mar 31, 2014
Melissa Nicole Lennon Individual W-2 Managing EmployeeSr. Claims System Analyst Sep 26, 2023
Steve Roach Individual Corporate Director Nov 1, 2013
Douglas Brown Individual Corporate OfficerPresident Jan 25, 2013
Corporate Director Jan 25, 2013
Randall Becker Individual Corporate Director Jul 1, 2021
Edward Moore Individual Corporate OfficerCeo Aug 1, 2007
W-2 Managing Employee Aug 1, 2007
Michael a Mahan Individual Corporate Director Mar 31, 2018
Wendy L Horr Individual W-2 Managing EmployeeProvider Enrollment Specialist Feb 3, 2014
John Glassburn Individual Corporate OfficerSecretary Apr 1, 2016
Heidi Ann Nano Individual W-2 Managing EmployeeManager, Pre Billing and Claims Sep 26, 2023
Jack Wilson Individual Corporate Director Mar 31, 2018
James Leary Individual Corporate Director Dec 1, 2018
Michael L Gustafson Individual Corporate Director Dec 1, 2018
Debra M Wooldridge Individual W-2 Managing EmployeeSupervisor, Provider Enrollment Jul 1, 2021
Eric William Dickson Individual Corporate Director Mar 31, 2013
Umass Memorial Community Hospitals Organization, Worcester, MA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2021 100%
Steven M McCue Individual Corporate OfficerCfo Jun 27, 2024
Luis Maseda Individual Corporate Director Oct 1, 2017
William McGrail Individual Corporate Director Oct 1, 1997
William F Corbett Individual Corporate Director Oct 1, 2017
Robert Paulhus Individual Corporate Director Oct 1, 2017
Michael Murphy Individual Corporate Director Mar 31, 2008
Marilyn C Amaya Individual W-2 Managing EmployeeProvider Enrollment Specialist Jul 1, 2021

Owners & managing parties with NPI records 1

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 169

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 169

Affiliated clinicians 976

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

View all 976

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1790780047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SOUTH STREET",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "01550",
            "telephone_number": "508-765-9771",
            "fax_number": "508-764-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SOUTH STREET",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "01550",
            "telephone_number": "508-765-9771",
            "fax_number": "508-764-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMASS MEMORIAL HEALTH-HARRINGTON HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-14",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "BRONHARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "617-224-7634",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MA",
            "license": "57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

Verify at the official NPI Registry.