Provider Demographics
NPI:1992737761
Name:NEWTON-WELLESLEY HOSPITAL
Entity type:Organization
Organization Name:NEWTON-WELLESLEY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP OF FINANCE/CFO
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDERMOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-243-6381
Mailing Address - Street 1:2014 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1607
Mailing Address - Country:US
Mailing Address - Phone:617-243-6000
Mailing Address - Fax:617-243-6954
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1607
Practice Address - Country:US
Practice Address - Phone:617-243-6000
Practice Address - Fax:617-243-6954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 261QM1300X, 273R00000X
MA2075282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No273R00000XHospital UnitsPsychiatric UnitGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1002252Medicaid
MA737275OtherTUFTS PROF CORP 01
MA900042OtherHARVARD PILGRIM
MAM18312OtherBC - PSYCH CORP 01
MA70012222010101OtherBC - IP
MA70012222010108OtherBC ACUTE HOSPITAL
MA70012222020118OtherBC ACUTE HOSPITAL
MAM17582OtherBC FULL TIME CORP 01
MA0007106OtherNHP
CT3024155Medicaid
CT3071991Medicaid
MA70012222010130OtherBC - SURGICAL DAY CENTER
MAM18144OtherBC - PART TIME CORP 01
MA000000021988OtherBOSTON HEALTH NET
MA70012222010110OtherBC - OP
FL9013971Medicaid
MA1201433Medicaid
MA220101OtherOSCAR
MA70012222010138OtherBC - SURGICAL DAY CENTER
MA900042OtherHARVARD PILGRIM
MA22S101Medicare Oscar/Certification