NPIMap

Organization Active NPI

Manet Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Taunton, MA
National Provider Identifier
1861817504
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
4801 Issued in MA
Legal business name
MANET COMMUNITY HEALTH CENTER, INC.
Practice address
1 Washington Street
Suite 900
Taunton, MA 02780
Phone
(617) 690-6343
Fax
(617) 690-6903
NPI assigned
Mar 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Authorized official

Name
Cynthia Sierra
Title
Chief Executive Officer
Phone
(617) 404-4101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 4801 MA Primary

Addresses

Primary practice location

1 Washington Street
Suite 900
Taunton, MA 02780

Mailing address

110 W Squantum St
North Quincy, MA 02171-2122
Phone (617) 376-3030

Other identifiers 1

IdentifierTypeStateIssuer
1302841MedicaidMA

Other names 1

  • Manet Community Health Center Taunton Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140426000009 MA Part A Provider - Federally Qualified Health Center (FQHC) 4486555158 Practice locations: Taunton, MA

Federally qualified health center certification: CCN 221923

Legal name
MANET COMMUNITY HEALTH CENTER, INC.
Doing business as
MANET COMMUNITY HEALTH CENTER, INC. AT TAUNTON
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 19, 2014
Last certification
Jun 19, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 5, 1978 in MA
Enrollment address
1 Washington St
Taunton, MA 27805293

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Manet Community Health Center Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

1 Washington St
Ste 900
Taunton, MA 02780
Phone (617) 690-6343

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Cynthia Sierra Individual Corporate OfficerChief Jan 15, 2016 100%
Samantha Chen Individual Corporate Director Jan 15, 2019 100%
Zachary Eaton Individual Corporate Director Dec 16, 2014 100%
Neda Hovaizi Individual Corporate Director Jan 15, 2019 100%
Lawrence Flanagan Individual Corporate Director Feb 21, 2017 100%
Stephen Keches Individual Corporate Director Feb 21, 2017 100%
John D Brothers Individual Corporate DirectorBoard Member Dec 5, 2000
Joseph M Reardon Individual Corporate DirectorBoard Member May 1, 2007
Robert Griffin Individual Corporate DirectorBoard Member Jan 24, 2011
Lavinia M Roosa Individual Corporate Director Mar 10, 2014
W-2 Managing Employee Mar 10, 2014
Jane Kisielius Individual Corporate DirectorBoard Member Dec 17, 2017 75%
Grace McAuliffe Individual Corporate DirectorBoard Member Dec 17, 2017 75%
Anita Christie Individual Corporate DirectorBoard Member Dec 17, 2017 75%
Ivan S Wong Individual Corporate OfficerChief Financial Officer Oct 20, 2009
Corporate DirectorBoard Member Oct 20, 2009
Linda a Kelly Individual Corporate DirectorBoard Member May 6, 2006
Karen Ward Individual Corporate DirectorBoard Member Dec 17, 2017 75%
Roberto Costa Individual Corporate DirectorBoard Member Dec 17, 2017 75%
Nancy Wyrebek Individual Corporate DirectorBoard Member Dec 17, 2017 75%
Anne Bisson Individual Corporate Director Nov 15, 2016 100%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1861817504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W SQUANTUM ST",
            "city": "NORTH QUINCY",
            "state": "MA",
            "postal_code": "021712122",
            "telephone_number": "617-376-3030",
            "fax_number": "617-690-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON STREET",
            "address_2": "SUITE 900",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "02780",
            "telephone_number": "617-690-6343",
            "fax_number": "617-690-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANET COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "SIERRA",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-404-4101"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MA",
            "license": "4801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1302841",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manet Community Health Center Taunton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taunton, MA

Sources for this page

Verify at the official NPI Registry.