FENWAY COMMUNITY HEALTH CENTER INC NPI 1003804725

NPI Information

  • NPI: 1003804725
  • Provider Name: FENWAY COMMUNITY HEALTH CENTER, INC
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Doing Business As: FENWAY HEALTH
  • Address: 1340 BOYLSTON ST
    BOSTON, MA
    ZIP 02215
  • Phone: (617) 927-4880

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NPI Details

FENWAY COMMUNITY HEALTH CENTER, INC is a federally qualified health center (fqhc) clinic center in Boston, MA. FENWAY COMMUNITY HEALTH CENTER, INC NPI is 1003804725. The provider is registered as an organization entity type.
The provider Is Doing Business As Fenway Health.

The provider's business location address is:

1340 BOYLSTON ST
BOSTON, MA
ZIP 02215-302
Phone: (617) 927-4880

The provider's authorized official is Jeff Lieberman .
The authorized official title is Vp Finance & Administration and has the following contact phone number (617) 927-6173.

The enumeration date for this NPI number is 10/6/2005 and was last updated on 7/7/2011.

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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)4519MASSACHUSETTSNo
2261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)4519MASSACHUSETTSYes

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
11303546MEDICAIDMASSACHUSETTS
2Y10138MEDICARE PINMASSACHUSETTS
3221867MEDICARE OSCAR/CERTIFICATIONMASSACHUSETTS

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: 11/21/2025

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