DIMOCK COMMUNITY HEALTH CENTER, INC (NPI# 1588719488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588719488 |
| Entity Type | Organization |
| Organization Name | DIMOCK COMMUNITY HEALTH CENTER, INC |
| Other Organization Name | THE DIMOCK CENTER |
| Practice Address |
45 Dimock St Roxbury MA 02119-1208 |
| Mailing Address |
55 Dimock St Roxbury MA 02119-1029 |
| Practice Telephone | 6174428800 |
| Practice Fax Number | 6174424088 |
| Mailing Telephone | 6174428800 |
| Mailing Fax Number | 6174424088 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2019-11-20 |
| Authorized Official Name | MR. PETER GERONDEAU (CFO/SVP) |
| Authorized Official Telephone | 6174428800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
MA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | MEDICARE UGS | 221862 | 01 |
| MA | 1301144 | 05 |
| Other Name | Type Code |
|---|---|
| The Dimock Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DIMOCK COMMUNITY HEALTH CENTER, INC. | 55 Dimock St, Boston, MA 02119-1029 |
| Street Address |
45 DIMOCK ST |
| City | ROXBURY |
| State | MA |
| Zip Code | 02119-1208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104813856 | Debra Jean Reid | Pharmacist | 45 Dimock St, Roxbury, MA 02119-1208 | 2005-09-27 |
| 1063022028 | Hoda Hamed | Optometrist | 45 Dimock St, Roxbury, MA 02119-1208 | 2020-08-05 |
| 1790394096 | Jonathan Foster-moore | Nurse Practitioner | 45 Dimock St, Roxbury, MA 02119-1208 | 2020-07-23 |
| 1730797077 | Kristie Michelle Grimes-mallard | Registered Nurse | 45 Dimock St, Roxbury, MA 02119-1208 | 2020-07-22 |
| 1558987859 | Dina Cabrejos Arauco | Social Worker | 45 Dimock St, Roxbury, MA 02119-1208 | 2020-06-23 |
| 1104440908 | Joelle Sulistio | Registered Nurse | 45 Dimock St, Roxbury, MA 02119-1208 | 2020-06-08 |
| 1346883980 | Kristen Monique Beard | Registered Nurse | 45 Dimock St, Roxbury, MA 02119-1208 | 2019-10-27 |
| 1639731649 | Alyssa Meltzer | Social Worker | 45 Dimock St, Roxbury, MA 02119-1208 | 2019-07-01 |
| 1184283012 | Claudia Rizzo | Social Worker | 45 Dimock St, Roxbury, MA 02119-1208 | 2019-06-13 |
| 1740849959 | Sabiha Zaman | Social Worker | 45 Dimock St, Roxbury, MA 02119-1208 | 2019-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427661644 | Christina Kim Hunt | Case Manager/Care Coordinator | 75 Amory St, Garden Level, Boston, MA 02119 | 2020-08-27 |
| 1962021089 | Taha Fathima Khan | Student in an Organized Health Care Education/Training Program | Boston Medical Center, 801 Albany Street, 3rd Floor, Department of Pediatrics, Boston, MA 02119 | 2020-04-09 |
| 1154957132 | Katherine Erin Douglas | Pediatrics | 801 Albany Street, 3rd Floor, Department of Pediatrics, Boston, MA 02119 | 2020-03-21 |
| 1720536568 | Ramy Y Barrett | Counselor | 77 Savin Street, Apartment # 3, Boston, MA 02119 | 2016-09-21 |
| 1083089676 | Natasha Cruz | Counselor | 263 Eustis Street, Roxbury, MA 02119 | 2015-12-08 |
| 1922478486 | Natalie Jones | Counselor | 520 Dudley St., Roxbury, MA 02119 | 2015-09-28 |
| 1922484799 | Dina Ghaly-habib | Student in an Organized Health Care Education/Training Program | 100 East Newton St., G-706, Boston, MA 02119 | 2015-08-04 |
| 1942697248 | Pyramid Builders | Case Management | 11 Roxbury Street, Boston, MA 02119 | 2015-04-24 |
| 1063810984 | Sophia Smalls | Counselor | 250 Walnut Ave, Apt. 10, Boston, MA 02119 | 2014-12-09 |
| 1750705059 | Alasa Hawkins | Counselor | 502 Dudley St, Roxbury, MA 02119 | 2014-02-07 |
| Find all providers in zip 02119 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1053729426 | Community Health Connections, Inc. | Clinic/Center | 140 Arnhow Farm Road, Fitchburg, MA 01420-1369 | 2014-07-29 |
| 1689092595 | Lowell Community Health Center, Inc. | Clinic/Center | 101 Jackson St, Lowell, MA 01852-2103 | 2014-03-29 |
| 1912272899 | Community Health Programs, Inc | Clinic/Center | 19 Depot Street, Adams, MA 01220 | 2012-03-12 |
| 1225323777 | Family Health Center of Worcester, Inc. | Clinic/Center | 14 Richards St, Goddard Health Center, Worcester, MA 01603-2609 | 2011-06-13 |
| 1801181334 | Family Health Center of Worcester, Inc. | Clinic/Center | 140 Apricot St, Sullivan Middle Health Center, Worcester, MA 01603-1225 | 2011-06-13 |
| 1720373251 | Family Health Center of Worcester, Inc. | Clinic/Center | 299 Highland St, Doherty School Based Health Center, Worcester, MA 01602-2110 | 2011-06-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.