Southcoast Hospitals Group, Inc
Organization Active NPI General Acute Care Hospital · Wareham, MA
NPI 1922024835 · NPPES record last updated May 27, 2009
Key facts
- NPI
- 1922024835
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- V113 (MA)
- Legal business name
- SOUTHCOAST HOSPITALS GROUP, INC
- Practice address
- 43 High St
Wareham, MA 02571-2097 - Phone
- (508) 295-0880
- NPI assigned
- Jul 14, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTHCOAST HEALTH SYSTEM, INC
Authorized official
- Name
- Mr. William E Grigg, CPA, FHFMA
- Title
- Executive Vice President & Cfo
- Phone
- (508) 961-5016
Parent organization (reported in NPPES) 1
Owners & managing parties with NPI records 4
-
Salman Bashir, MD
-
Ilana L Feinerman, M.D.
-
Jay S Schachne, MD
-
Anil Shukla, MD
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 1
Related certifications (CCN) 2
Practitioners 96
-
David J Farber, MD
-
Chelsea Rae Manzone, FNP
-
Barbara Dannielle Phelps, NP-C
-
Ashley Carol Roy, PA-C
-
Philip J Sabra, M.D.
-
David Stebbins, MD
-
Robert Vazquez, M.D.
-
Ravi Chander, M.D.
-
Catherine Darah Jones, PA-C
-
Erin J Senay, FNP-BC
-
Eileen Celeste Bernier, MA, CCC-A
-
Sarah A. Bernier, M.D.
-
Michael A Campbell, D.O.
-
Keith Newman Chappell, M.D.
-
Peter S Cohn, MD
-
Hayden J Costa, AGACNP
-
Farrel Douglas, MD
Affiliated clinicians 1,578
-
Amtul Aala, MD
-
Adam Abboud, DPM
-
Bethany Jane Abde, AGNP - BC
-
Ramy Abu Sukheila, M.D
-
Michael D Achey, MD
-
Sofia Adamidi, MD
-
Kristy Adams, CNP
-
Lisa Ann Adams, MD
-
Abena A. Addo, MD
-
Dorcas Adeyemi Adeyemo, DNP, FNP-C, PMHNP-BC
-
Arielle L Adrien-Jean, M.D.
-
Gloriane Afonso-Fede, M.D.
-
Jessica Maria Agaran, NP-C
-
Purva Agarwal, M.D.
-
Dineli N. Ahearn, M.D.
-
Mahmood Ahmad, M.D
-
Munir Ahmed, MD
-
Michele Albert, MD
Medicare Care Compare: Hospital
- Listed as
- Southcoast Hospitals Group
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D0080852 | Tobey Hospital Laboratory | Accreditation | Jan 2, 2027 |
| 22D0874987 | Tobey Hospital Blood Gas Laboratory | Accreditation | Dec 28, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MA
Hospital certification: CCN 220074
- Legal name
- SOUTHCOAST HOSPITALS GROUP INC
- Doing business as
- TOBEY HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Nov 5, 1998
- Beds
- 695
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 9, 1984 in MA
- Enrollment address
- 43 High St
Wareham, MA 25712097 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 19
| Name | Role | Since | Share |
|---|---|---|---|
| Elizabeth Huidekoper |
Corporate Officer | Jan 1, 2022 | |
| Renee Clark |
Corporate Officer | Jan 1, 2022 | |
| W Hugh Morton |
Corporate Officer | Jan 1, 2022 | |
| Donald G Giumetti |
Corporate Officer | Jan 1, 2022 | |
| Johnathan L Rounds |
Corporate Officer | Jan 1, 2022 | |
| Anil Shukla |
Corporate Officer | Jan 1, 2024 | |
| David O McCready |
Corporate Officer | Oct 1, 2023 | |
| Jay S Schachne |
Corporate Officer | Jan 1, 2022 | |
| Salman Bashir |
Corporate Officer | Jan 1, 2022 | |
| Michael J Bushell |
Corporate Officer |
Oct 7, 2024 | |
| Louis a Cabral |
Corporate Officer | Jan 1, 2022 | |
| Christopher M Hodgson |
Corporate Officer | Jan 1, 2022 | |
| Helena Dasilva Hughes |
Corporate Officer | Jan 1, 2022 | |
| Philip Rapoza |
Corporate Officer | Jan 1, 2024 | |
| Ilana Louise Feinerman |
Corporate Officer | Jan 1, 2022 | |
| Jason Rua |
Corporate Officer | Jan 1, 2022 | |
| Michael Knoll |
W-2 Managing Employee |
Jul 17, 2017 | |
| Dennis J Fusco |
Corporate Officer | Jan 1, 2022 | |
| Carmen F Sylvester |
Corporate Officer | Jan 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041214000621 | MA | Part B Supplier - Clinic/Group Practice | 1850282310 |
Receives reassigned benefits from 170 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Westport, MA; Wareham, MA; Fall River, MA; Swansea, MA; North Dartmouth, MA; New Bedford, MA; Fairhaven, MA |
| O20070215000406 | MA | Part a Provider - Hospital | 1850282310 | Practice locations: Wareham, MA |
National Provider Directory
- Tax ID family
- Charlton Memorial Hospital - Rehab
- Part of
- Southcoast Health System Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | V113 | MA | Yes |
Addresses
Primary practice location
43 High St
Wareham, MA 02571-2097
Mailing address
363 Highland Ave
Fall River, MA 02720-3703
Phone (508) 679-3131
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12923 | Other | AETNA | |
| 208299800 | Other | US DEPT OF LABOR | |
| 2222007410 | Other | BLUE CROSS MA | |
| OP20074 | Medicaid | RI | |
| 110022082D | Medicaid | MA | |
| 2222007430 | Other | BLUE CROSS MA | |
| 900016 | Other | HARVARD PILGRIM | |
| 0000005119 | Other | BLUE CROSS RI | |
| 0220074 | Medicaid | RI | |
| 0462672 | Other | CIGNA | |
| 904193 | Other | TUFTS | |
| S012225 | Other | TRICARE FOR LIFE | |
| 110022082H | Medicaid | MA | |
| 000000020854 | Other | BMC HEALTHNET | |
| 1201751 | Other | MA BEHAVIORAL HEALTH PART | |
| 220074 | Other | MA | MEDICARE |
| 2222007401 | Other | BLUE CROSS MA | |
| 5000103 | Other | UNITED HEALTH PLANS | |
| 900032 | Other | TUFTS |
Other names
- Tobey Hospital
Other providers in Wareham, MA
- Beatriz R Sousa
- Kirsten Marie Sousa
- Southcoast Dental, PLLC
- Southcoast Hospitals Group Inc
- Southcoast Hospitals Group, Inc
- Southcoast Physician Services, Inc.
- Southcoast Physicians Group, Inc.
- Southcoast Physicians Group, Inc.
- Laurence D Spector
- Theodore A Spevack
All providers in Wareham, 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 May 27, 2009. 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.