Elliot Hospital of the City of Manchester

Primary specialty

Psychiatric Hospital UnitTaxonomy code 273R00000X

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 26, 2006

Organization subpart

No

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

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Hospital certification: CCN 30S012

Legal name

ELLIOT HOSPITAL OF THE CITY OF MANCHESTER

Organization structure

CorporationNon-profit

Incorporated

Jan 1, 1890 in NH

Enrollment address

1 Elliot Way
Pathways Unit Floor 4 of Main Building
Manchester, NH 3103
Hospital Psychiatric Unit

Hospital subgroups

Psychiatric unit

Related certifications (CCN) 1

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

• Elliot Hospital of the City of Manchester

  • General Acute Care Hospital
  • Manchester, NH
  • NPI 1902996028

  Unit of hospital

  Provider of Services

Other NPIs with the same Medicare PAC ID 4

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

• Elliot Hospital of the City of Manchester

  • Durable Medical Equipment & Medical Supplies
  • Manchester, NH
  • NPI 1427325729

  3173434982

  Same PAC ID
• Elliot Hospital of the City of Manchester

  • Durable Medical Equipment & Medical Supplies
  • Manchester, NH
  • NPI 1689764482

  3173434982

  Same PAC ID
• Elliot Hospital of the City of Manchester

  • Community/Retail Pharmacy
  • Manchester, NH
  • NPI 1881031854

  3173434982

  Same PAC ID
• Elliot Hospital of the City of Manchester

  • General Acute Care Hospital
  • Manchester, NH
  • NPI 1902996028

  3173434982

  Same PAC ID

Locations

All disclosed owners & managing parties 26

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

Owners & managing parties with NPI records 5

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

• Carl M Fier, MD

  • Interventional Cardiology Physician
  • Manchester, NH
  • NPI 1841268224

  Corporate Director

  CMS ownership
• Nancy S. Husarik, MD

  • Pediatrics Physician
  • Raymond, NH
  • NPI 1467443168

  Corporate Director

  CMS ownership
• Marjan Makatam-Abrams, M.D.

  • Pediatric Adolescent Medicine Physician
  • Manchester, NH
  • NPI 1871605022

  Corporate Director

  CMS ownership
• Heidi L Meinz, M.D.

  • Obstetrics & Gynecology Physician
  • Manchester, NH
  • NPI 1841285236

  Corporate Director

  CMS ownership
• Marina I Feldman, MD, MBA

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1215123815

  Corporate Director

  CMS ownership

Practitioners 3

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

• Akash Jwalant Vadalia, DO, MPH

  • Psychiatry Physician
  • Manchester, NH
  • NPI 1225564222
  NPD (past)
• Judah David Weathers, M.D.

  • Psychiatry Physician
  • Derry, NH
  • NPI 1730523754
  NPD (past)
• Sorin N Nica, MD

  • Psychiatry Physician
  • Wheeling, WV
  • NPI 1457665325
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1992880009",
    "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": "031012040",
            "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": "2006-10-26",
        "last_updated": "2011-03-17",
        "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": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NH",
            "license": "00018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30002654",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elliot Hospital of the City of Manchester
• Elliot Hospital of the City of Manchester
• Elliot Hospital of the City of Manchester
• Elliot Hospital of the City of Manchester
• Elliot Hospital of the City of Manchester
• Elliot Physician Network
• Elliot Physician Network
• Elliot Physicians Network
• Elliot Physicians Network
• Elliot Physicians Network

• All providers in Manchester, NH
• Psychiatric Hospital Unit in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.