NPIMap

Organization Active NPI

Melrosewakefield Healthcare, Inc.

  • General Acute Care Hospital
  • Medford, MA
National Provider Identifier
1841290467
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
VKB3 Issued in MA
Legal business name
MELROSEWAKEFIELD HEALTHCARE, INC.
Practice address
170 Governors Ave
Medford, MA 02155-1643
Phone
(781) 979-3050
NPI assigned
Jul 26, 2005
Last updated
Jul 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Susan Green
Title
Evp Chief Financial Officer
Phone
(787) 887-1439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X VKB3 MA Primary

Addresses

Primary practice location

170 Governors Ave
Medford, MA 02155-1643

Mailing address

170 Governors Ave
Medford, MA 02155-1643

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031212000632 MA Part A Provider - Hospital 8224935838 Practice locations: Medford, MA; Melrose, MA; Reading, MA; Stoneham, MA; Wakefield, MA
O20040504000734 MA Part B Supplier - Clinic/Group Practice 8224935838 Receives reassigned benefits from 146 practitioners
1 other NPI on this enrollment
Practice locations: Medford, MA; Stoneham, MA; Melrose, MA; Malden, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841290467. Details of each certification follow.

Hospital certification: CCN 220070

Legal name
MELROSEWAKEFIELD HEALTHCARE, INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Dec 11, 2009
Beds
538 (128 certified)
Ownership / control type
Private (not for profit)
Most recent change of ownership
Oct 1, 1997 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Aug 13, 1982 in MA
Enrollment address
170 Governors Ave
Medford, MA 21551643
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Rehabilitation

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Melrosewakefield HealthcareCCN 220070 · 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
Tax ID family
Hallmark Health System Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

587 Lebanon St
Melrose, MA 02176

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
William F Wyman Individual Corporate OfficerAssistant Treasurer Nov 1, 2020
W-2 Managing EmployeeSVP of Operations Nov 1, 2021
Charles R. Whipple Individual Corporate OfficerAssistant Secretary May 10, 2018
W-2 Managing Employee May 10, 2018
Operational/Managerial ControlAssistant Secretary May 10, 2018
Courtney Mitchell Individual W-2 Managing Employee Dec 1, 2019
Tanya Thorpe Individual W-2 Managing Employee Oct 15, 2022
Wellforce Inc Organization, Burlington, MA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2017 100%

Practitioners & affiliated clinicians

Practitioners 196

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 196

Affiliated clinicians 675

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

View all 675

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1841290467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 GOVERNORS AVE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 GOVERNORS AVE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551643",
            "telephone_number": "781-979-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELROSEWAKEFIELD HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "EVP CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "787-887-1439"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MA",
            "license": "VKB3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.