NPIMap

Organization Active NPI

Amoskeag Health

  • Federally Qualified Health Center (FQHC)
  • Manchester, NH
National Provider Identifier
1902495930
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
AMOSKEAG HEALTH
Practice address
75 Parkside Ave RM 142
Manchester, NH 03102-3603
Phone
(603) 626-9500
Fax
(833) 448-1486
NPI assigned
Jan 14, 2021
Last updated
Jul 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Authorized official

Name
Kristen McCracken
Title
President/Ceo
Phone
(603) 626-9500

Specialties & licenses 1

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

Addresses

Primary practice location

75 Parkside Ave RM 142
Manchester, NH 03102-3603

Mailing address

145 Hollis St
Manchester, NH 03101-1235
Phone (603) 626-9500

Other names 1

  • Amoskeag Health at Parkside Middle School Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040728001071 NH Part B Supplier - Clinic/Group Practice 8527038421 Receives reassigned benefits from 79 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manchester, NH
O20210130000205 NH Part A Provider - Federally Qualified Health Center (FQHC) 8527038421 Practice locations: Manchester, NH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902495930. Details of each certification follow.

Federally qualified health center certification: CCN 301842

Legal name
AMOSKEAG HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 30, 2021
Last certification
Jan 30, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 17, 1992 in NH
Enrollment address
75 Parkside Ave
RM 142
Manchester, NH 31023603

Other NPIs with the same Medicare PAC ID 17

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

View all 17

Other NPIs on the same Medicare enrollment 20

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

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Manchester Community Health19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

184 Tarrytown Rd
Manchester, NH 03103
Phone (603) 627-1102

75 Parkside Ave
Rm 142
Manchester, NH 03102

88 McGregor St
Ste 302
Manchester, NH 03102
Phone (603) 622-8800

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Obhed Giri Individual Corporate Director Dec 1, 2020
Thomas Lavoie Individual Corporate Director Oct 1, 2019
Steven a Paris Individual Corporate Director May 7, 2024
Madhab Gurung Individual Corporate Director Jan 7, 2020
Oreste J Mosca Individual Corporate Director Feb 6, 2018
Debra Manning Individual Corporate Director Nov 5, 2019
Normand Fortin Individual Corporate Director Apr 8, 2025
Karen Schoch Individual Corporate Director Nov 5, 2024
Kristen McCracken Individual Corporate OfficerCeo/President Dec 31, 2013
Anna Hamel Individual Corporate Director Mar 4, 2025
Karine St. Surin Individual Corporate Director Jun 4, 2024
Dominique Demartino Individual W-2 Managing EmployeeBilling Department Manager May 15, 2023
Jamie Adam Pike Individual Corporate Director Jan 7, 2025
Dawn McKinney Individual Corporate Director Jul 11, 2017
Tiffany Johnson Individual Corporate Director Aug 5, 2025
Richard a Elwell Individual Corporate DirectorTreasurer Jan 9, 2018
Timothy Donovan Individual Corporate Director Apr 8, 2025

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 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1902495930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HOLLIS ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011235",
            "telephone_number": "603-626-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PARKSIDE AVE RM 142",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031023603",
            "telephone_number": "603-626-9500",
            "fax_number": "833-448-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMOSKEAG HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-14",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "MCCRACKEN",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "603-626-9500"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amoskeag Health at Parkside Middle School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.