Melrosewakefield Healthcare, Inc.
Organization Active NPI General Acute Care Hospital · Medford, MA
NPI 1841290467 · NPPES record last updated Jul 10, 2023
Key facts
- NPI
- 1841290467
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- VKB3 (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
- Organization subpart
- No
Authorized official
- Name
- Susan Green
- Title
- Evp Chief Financial Officer
- Phone
- (787) 887-1439
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 3
Related certifications (CCN) 1
Practitioners 196
-
Michael Drake Alpert, M.D.
-
Pearl Alweny, NP
-
Can Bulucu, M.D.
-
Tracy Daly, FNP-C
-
Astrid Desrosiers, MD MPH
-
Philip D Gottlieb, M.D.
-
Catline Jacques, M.D.
-
Amal Kimawi, M.D
-
James Lech, M.D.
-
Cara Steffanie Leonard, PMHNP
-
Shuang Li, M.D.
-
Lusha Liu, M.D.
-
Kathleen McGuiggan, N.P.
-
Candice Noke, CNP
-
Rizwana Sabeeh, MD
-
Tess Stevens, FNP
-
Qiang Zeng, MD
-
Scott Pladel, PA-C
-
Dana Joy Emo, PA-C
Affiliated clinicians 675
-
Joshua Abrahams, AGPCNP-BC
-
Dineli N. Ahearn, M.D.
-
Kerrill J Allen, NP
-
Steven Alter, MD
-
Kathleen Ammon, NP
-
Kimberly A Amouzgar, CRNA
-
Christina Anderlind, M.D.
-
Brett Aponas, PA-C
-
Kristen McCarthy Aprile, PA-C
-
Miguel A Ariza, M.D.
-
May Azar, M.D.
-
Hongwei Bai, M.D.
-
Anjum Baqai, M.D.
-
Marianne Barry, M.D.
Medicare Care Compare: Hospital
- Listed as
- Melrosewakefield Healthcare
- Overall star rating
- ★★★☆☆ 3 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MA
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
- Corporation · Non-profit
- Incorporated
- Aug 13, 1982 in MA
- Enrollment address
- 170 Governors Ave
Medford, MA 21551643 - Hospital subgroups
- General, Acute care, Rehabilitation
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| William F Wyman |
Corporate Officer |
Nov 1, 2020 | |
| W-2 Managing Employee |
Nov 1, 2021 | ||
| Charles R. Whipple |
Corporate Officer |
May 10, 2018 | |
| W-2 Managing Employee | May 10, 2018 | ||
| Operational/Managerial Control |
May 10, 2018 | ||
| Courtney Mitchell |
W-2 Managing Employee | Dec 1, 2019 | |
| Tanya Thorpe |
W-2 Managing Employee | Oct 15, 2022 | |
| Wellforce Inc |
5% Or Greater Indirect Ownership Interest | Jan 1, 2017 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Hallmark Health System Inc
Locations
587 Lebanon St
Melrose, MA 02176
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | VKB3 | MA | Yes |
Addresses
Primary practice location
170 Governors Ave
Medford, MA 02155-1643
Mailing address
170 Governors Ave
Medford, MA 02155-1643
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000403 | Medicaid | MA | |
| 900147 | Other | MA | HP LAWRENCE ALL |
| 900262 | Other | MA | HP MELROSE ALL |
| 0018036 | Other | MA | NHP ALL |
| 0018183 | Other | MA | NHP FHC |
| 1004805 | Other | MA | NHP PSYCH OP |
| 2222007030 | Other | MA | BC SDC |
| 2222007001 | Other | MA | BC INPATIENT |
| 900012 | Other | MA | TUFTS LAWRENCE INPATIENT |
| 905174 | Other | MA | TUFTS MELROSE OUTPATIENT |
| 996129 | Other | MA | NETWORK ALL |
| 1903241 | Medicaid | MA | |
| 905178 | Other | MA | TUFTS MALDEN AND FHC |
| 2222007010 | Other | MA | BC OUTPATIENT |
| 905173 | Other | MA | TUFTS MELROSE INPATIENT |
| 1211382 | Medicaid | MA | |
| 1200992 | Medicaid | MA | |
| 900005 | Other | MA | TUFTS LAWRENCE OUTPATIENT |
| 900348 | Other | MA | HP MALDEN |
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All providers in Medford, MA · General Acute Care Hospital in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2023. 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.