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Springfield Medical Care Systems Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Springfield, VT

NPI 1992073191 · NPPES record last updated Oct 31, 2024

Key facts

NPI
1992073191
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
SPRINGFIELD MEDICAL CARE SYSTEMS INC
Practice address
100 River St
Springfield, VT 05156-2930
Phone
(802) 885-5100
NPI assigned
Dec 2, 2011
Organization subpart
No

Authorized official

Name
Andrew Majka
Title
Cfo
Phone
(802) 886-8950

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 5

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

Corporate family (same tax ID) 16

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

Practitioners 52

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

View all 52

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VT

Federally qualified health center certification: CCN 471839

Legal name
SPRINGFIELD MEDICAL CARE SYSTEMS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 12, 2012
Last certification
Jan 12, 2012
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
May 12, 1982 in VT
Enrollment address
100 River St
Springfield, VT 51562930

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Stephen J Varone
Individual 		Corporate Director Dec 8, 2020
Cheryl a Sanctuary
Individual 		Corporate Director Jan 6, 2021 100%
Susan P White
Individual 		Corporate Director Oct 26, 2021 100%
Andrew J Majka
Individual 		Corporate Officer
Cfo		 Jan 1, 2023 100%
W-2 Managing Employee Jan 1, 2023
Kendra E Ingalls
Individual 		Corporate Director Feb 8, 2019 100%
W-2 Managing Employee Feb 8, 2019 100%
Joshua R Dufresne
Individual 		Corporate Officer
Ceo		 Dec 1, 2018 100%
W-2 Managing Employee Dec 1, 2018
Jennifer L Anderson
Individual 		Corporate Director Oct 26, 2021 100%
Anthony P Petrillo
Individual 		Corporate Director Dec 8, 2020
Amanda M McLeod
Individual 		Corporate Director
Board Member		 Oct 26, 2021 100%
Edmond H Moore
Individual 		Corporate Director Dec 28, 2020
Kelly M Pajala
Individual 		Corporate Director Oct 26, 2021 100%

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Springfield Hospital Inc.
Springfield, VT · CCN 471306		 Hospital 5% Or Greater Indirect Ownership Interest (100%) May 12, 1982
Springfield Hospital Inc.
Springfield, VT · CCN 47Z306		 Hospital 5% Or Greater Indirect Ownership Interest (100%) May 12, 1982

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20111219000404 VT Part a Provider - Federally Qualified Health Center (FQHC) 9133157043 Practice locations: Springfield, VT

National Provider Directory

Tax ID family
Springfield Medical Care Systems Inc (17 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

100 River St
Springfield, VT 05156-2930

Mailing address

PO Box 710
Springfield, VT 05156-0710
Phone (802) 886-8950

Other providers in Springfield, VT

All providers in Springfield, VT · Federally Qualified Health Center (FQHC) in Vermont

Sources for this page

Verify at the official NPI Registry.