Provider Demographics
NPI:1699767491
Name:NEW ENGLAND BAPTIST HOSPITAL
Entity type:Organization
Organization Name:NEW ENGLAND BAPTIST HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:PASSAFARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-754-5001
Mailing Address - Street 1:125 PARKER HILL AVE
Mailing Address - Street 2:
Mailing Address - City:ROXBURY CROSSING
Mailing Address - State:MA
Mailing Address - Zip Code:02120-2847
Mailing Address - Country:US
Mailing Address - Phone:617-754-5800
Mailing Address - Fax:617-754-6418
Practice Address - Street 1:125 PARKER HILL AVE
Practice Address - Street 2:
Practice Address - City:ROXBURY CROSSING
Practice Address - State:MA
Practice Address - Zip Code:02120-2847
Practice Address - Country:US
Practice Address - Phone:617-754-5800
Practice Address - Fax:617-754-6418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2059282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1000543Medicaid
MA903897OtherTUFTS INPATIENT
MANEW2222008810OtherBLUE CROSS OUTPATIENT
MA900033OtherTUFTS OUTPATIENT
MA900073OtherHARVARD PILGRIM INPT/OUTP
MANEW2222008830OtherBLUE CROSS DAY SURGERY
MD728263OtherTUFTS SNF
MANEW2222556301OtherBLUE CROSS SNF
MA1201336Medicaid
MANEW2222008801OtherBLUE CROSS INPATIENT
MANEW2222008801OtherBLUE CROSS INPATIENT
MA220088Medicare Oscar/Certification