MEDICARE: MATTAPAN COMMUNITY HEALTH CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center
2	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639240393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATTAPAN COMMUNITY HEALTH CENTER INC

Provider Business Mailing Address
First Line	:	1575 BLUE HILL AVE
Second Line	:
City	:	MATTAPAN
State	:	MA
Zip	:	02126-2122
Country	:	US
Telephone Number	:	617-296-0061
Fax Number	:	617-296-5408

Provider Business Practice Location Address
First Line	:	1575 BLUE HILL AVE
Second Line	:
City	:	MATTAPAN
State	:	MA
Zip	:	02126-2122
Country	:	US
Telephone Number	:	617-296-0061
Fax Number	:	617-296-5408

Authorized Official
Title or Position	:	PRESIDENT & CHIEF EXECUTIVE OFFICER
Name	:	GUALE VALDEZ
Credential	:
Telephone Number	:	617-898-9090

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	04/29/2019

Similar Medicare Providers

1730184854 — CHRISTOPHER W SHANAHAN M.D., M.P.H.
Practice Location Address:

1575 BLUE HILL AVE
MATTAPAN, MA
02126-2122

Practice Phone: 617-829-6006
Practice Fax: 617-296-5408

1396733838 — DR. JOSE D CARIZ MD
Practice Location Address:

1575 BLUE HILL AVE
MATTAPAN, MA
02126-2122

Practice Phone: 617-296-0061
Practice Fax:

1982781977 — TARMA JEAN JOHNSON FNP-BC
Practice Location Address:

1575 BLUE HILL AVE
MATTAPAN, MA
02126-2122

Practice Phone: 617-898-9057
Practice Fax: 617-296-5408

1235250515 — RONALD CLINE DBA VISION SPECIALISTS
Practice Location Address:

1587 BLUE HILL AVE
MATTAPAN, MA
02126-2122

Practice Phone: 617-298-6998
Practice Fax:

1942429915 — DR. ROBERT BRETT SHERRY D.C.
Practice Location Address:

1551 BLUE HILL AVE
MATTAPAN, MA
02126-2122

Practice Phone: 617-298-3200
Practice Fax: 617-298-3233

1144425059 — MEDICAL CENTER OF GREATER MATTAPAN
Practice Location Address:

1603 BLUE HILL AVE
MATTAPAN, MA
02126-2122

Practice Phone: 617-296-5710
Practice Fax: 617-296-6368

Directions to “MATTAPAN COMMUNITY HEALTH CENTER INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.