NPIMap

Organization Active NPI

Elliot Hospital of the City of Manchester

  • General Acute Care Hospital
  • Manchester, NH
National Provider Identifier
1902996028
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
00018 Issued in NH
Legal business name
ELLIOT HOSPITAL OF THE CITY OF MANCHESTER
Practice address
1 Elliot Way
Manchester, NH 03103-3502
Phone
(603) 663-2431
Fax
(603) 663-5820
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Authorized official

Name
Mr. Marc Cullerot
Title
Vice President of Finance
Phone
(603) 663-8977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 00018 NH Primary

Addresses

Primary practice location

1 Elliot Way
Manchester, NH 03103-3502

Mailing address

PO Box 2040
Manchester, NH 03105-2040
Phone (603) 663-2431

Other identifiers 6

IdentifierTypeStateIssuer
300012OtherNHANTHEM BLUE CROSS
80300012MedicaidNH
H000556OtherNHTRICARE
900122OtherNHHARVARD PILGRIM HEALTH PL
OTHEROtherNHMVP HEALTH PLAN
904223OtherNHTUFTS HEALTH PLAN

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmdprod.craneware.com.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Craneware, Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030723000036 NH Part A Provider - Hospital 3173434982 Practice locations: Manchester, NH; Milford, NH; Raymond, NH; Windham, NH; Allenstown, NH; Bedford, NH; Exeter, NH; Concord, NH…

Hospital certification: CCN 300012

Legal name
ELLIOT HOSPITAL OF THE CITY OF MANCHESTER
Doing business as
ELLIOT HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Nov 9, 2012
Beds
296
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jul 21, 1881 in NH
Enrollment address
1 Elliot Way
Manchester, NH 31033502
Main/Primary Hospital Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Elliot HospitalCCN 300012
Overall star rating
2 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
Elliot Adult Day Care10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 28

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

NameRoleSinceShare
Martha Leighton Individual Corporate OfficerCno Aug 28, 1995
W-2 Managing EmployeeCno Aug 28, 1995
Martha E Maunsell Individual W-2 Managing Employee Feb 26, 2023
Operational/Managerial Control Feb 26, 2023
Joyia E Fazelat Individual Corporate Director Feb 21, 2024
Eva Martel Individual Corporate Director Jun 1, 2022
William G Baxter Individual Corporate OfficerPresident Aug 31, 2018
Operational/Managerial ControlPresident & Ceo Jul 15, 2016
David Cuzzi Individual Corporate DirectorBoard Member Feb 17, 2019
Charles S Goodwin Individual Corporate DirectorTrustee Jan 20, 2022
Selma Naccach-Hoff Individual Corporate Director Feb 21, 2024
James C Hood Individual Corporate DirectorBoard Member Jan 1, 2007
John E Friberg Individual Corporate OfficerSenior Vice President General Co Jul 15, 2016
Operational/Managerial ControlSenior Vice President and Legal Jul 15, 2016
David Bellman Individual Corporate Director Jan 1, 2023
Robert Fremeau Individual Corporate Director Jan 1, 2023
Michael S Turilli Individual Corporate OfficerSVP Chief Financial Officer Jun 6, 2022
Operational/Managerial ControlSVP Chief Financial Officer Jun 6, 2022
Andrew Macwilliam Individual Corporate Director Feb 21, 2024
Loretta L.C. Brady Individual Corporate DirectorBoard Member Feb 1, 2017
Philip Taub Individual Corporate DirectorBoard Member Feb 17, 2019
Priscilla Simoan Marsicovetere Individual Corporate Director Feb 21, 2024
James J Tenn Individual Corporate DirectorBoard Member Jan 1, 2018
Elliot Health System Organization, Manchester, NH Operational/Managerial Control Dec 31, 1999
Joseph Curti Individual Corporate OfficerCoo Feb 11, 2019
W-2 Managing EmployeeCoo Feb 11, 2019
Carl M Fier Individual Corporate DirectorTrustee Feb 17, 2022
Linda C Lassonde Individual Corporate Director Jan 1, 2023
Lara C Hanlon Individual Corporate Director Feb 21, 2024
Richard Fischer Individual Corporate Director Feb 21, 2024
Todd Eric Burdette Individual Corporate Director Feb 21, 2024
Marina I Feldman Individual Corporate DirectorTrustee Jan 1, 2020
Karen Van Der Beken Individual Corporate DirectorTrustee Jan 20, 2022
Charles F Rolecek Individual Corporate DirectorBoard Member Jan 1, 2018

Owners & managing parties with NPI records 6

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 92

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

View all 92

Affiliated clinicians 1,300

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

View all 1,300

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1902996028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2040",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031052040",
            "telephone_number": "603-663-2431",
            "fax_number": "603-663-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033502",
            "telephone_number": "603-663-2431",
            "fax_number": "603-663-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOT HOSPITAL OF THE CITY OF MANCHESTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "CULLEROT",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "603-663-8977",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NH",
            "license": "00018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "300012",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80300012",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "H000556",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH PL",
            "identifier": "900122",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH PLAN",
            "identifier": "OTHER",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "904223",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmdprod.craneware.com.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.17.9.1",
            "affiliationName": "Craneware, Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3340 Peachtree Rd NE Ste 850",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303261072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.