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UPHAM'S CORNER HEALTH COMMITTEE INC. NPI 1316023195


NPI Information

NPI: 1316023195
Provider Name: UPHAM'S CORNER HEALTH COMMITTEE, INC.

Doing Business As: UPHAM'S ELDER SERVICE PLAN

Classification: Program of All-Inclusive Care for the Elderly (PACE) Provider Organization - 251T00000X
Entity Type: Organization

CLIA Number: 22D0683548

Address:
1140 DORCHESTER AVE
DORCHESTER, MA
ZIP 02125
Phone: (617) 288-0970
Get Directions

UPHAM'S CORNER HEALTH COMMITTEE, INC. is a program of all inclusive care for the elderly pace provider organization in Dorchester, MA. The provider is a PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. UPHAM'S CORNER HEALTH COMMITTEE, INC. NPI is 1316023195. The provider is registered as an organization entity type.
The provider Is Doing Business As Upham's Elder Service Plan.

The provider's business location address is:

1140 DORCHESTER AVE
DORCHESTER, MA
ZIP 02125-305
Phone: (617) 288-0970
Fax: (617) 474-0757

The provider's authorized official is Jagdeep Trivedi .
The authorized official title is Ceo and has the following contact phone number (617) 740-8131.

The CLIA number assigned to this NPI record is 22D0683548 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/27/2006 and was last updated on 7/12/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251T00000XProgram of All-Inclusive Care for the Elderly (PACE) Provider OrganizationYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11803344MEDICAIDMASSACHUSETTS
2H2220MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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