NPIMap

Organization Active NPI

Manchester Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Manchester, CT
National Provider Identifier
1881564664
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
MANCHESTER MEMORIAL HOSPITAL, INC.
Practice address
71 Haynes St
Manchester, CT 06040-4188
Phone
(860) 646-1222
NPI assigned
Nov 7, 2025
Last updated
Apr 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Authorized official

Name
Gerald Boisvert
Title
Senior Vice President, Financial Op
Phone
(860) 263-4190

Specialties & licenses 1

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

Addresses

Primary practice location

71 Haynes St
Manchester, CT 06040-4188

Mailing address

1290 Silas Deane Hwy Ste 102
Wethersfield, CT 06109-4337
Phone (860) 972-3075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20251203001468 CT Part A Provider - Hospital 1658864202 Practice locations: Vernon, CT; South Windsor, CT; Manchester, CT; Ellington, CT; Coventry, CT
O20260422002111 CT Part B Supplier - Clinic/Group Practice 1658864202 Receives reassigned benefits from 53 practitioners
1 other NPI on this enrollment
Practice locations: Manchester, CT; South Windsor, CT; Vernon, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881564664. Details of each certification follow.

Hospital certification: CCN 070027

Legal name
MANCHESTER MEMORIAL HOSPITAL, INC.
Doing business as
MANCHESTER MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 6, 2018
Beds
249
Ownership / control type
Private (for profit)
Most recent change of ownership
Jan 1, 2026 (2 total)
Organization structure
CorporationNon-profit
Enrollment address
71 Haynes St
Manchester, CT 60404131
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

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

Other NPIs with the same Medicare PAC ID 2

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
Manchester Memorial HospitalCCN 070027 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Gerald Boisvert Individual Corporate OfficerAo/Sr VP of Financial Operations Jan 1, 2026
W-2 Managing EmployeeAo/Sr VP of Financial Operations Jan 1, 2026
Sheryl Ann Decilio Individual Corporate DirectorHHC VP Finance Manchester Jan 1, 2026
W-2 Managing EmployeeHHC VP Finance Manchester Jan 1, 2026
Adam Steinberg Individual Corporate OfficerPresident of Hospital Jan 1, 2026
Chibueze Agba Individual Corporate DirectorDirector Jan 1, 2026
Hartford Healthcare Corporation Organization, Hartford, CT 5% Or Greater Direct Ownership Interest Jan 1, 2026 100%
Karen Goyette Individual Corporate DirectorDirector Jan 1, 2026
Jeffrey Flaks Individual Corporate OfficerPresident and Chief Executive of Jan 1, 2026
David Mack Individual Corporate DirectorDirector Jan 1, 2026

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 17

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 17

Practitioners & affiliated clinicians

Practitioners 53

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 53

Affiliated clinicians 595

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

View all 595

NPI Registry JSON

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

{
    "created_epoch": "1762473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1881564664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY STE 102",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "860-972-3075",
            "fax_number": "860-972-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404188",
            "telephone_number": "860-646-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANCHESTER MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-07",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "BOISVERT",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT, FINANCIAL OP",
        "authorized_official_telephone_number": "860-263-4190"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.