PINE STREET INN AT SHATTUCK
NPI 1962645572
Clinic/Center - Federally Qualified Health Center (FQHC) in Jamaica Plain, MA
About Pine Street Inn At Shattuck NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PINE STREET INN AT SHATTUCK (NPI 1962645572) is a healthcare organization registered as a federally qualified health center (fqhc) in Jamaica Plain, Massachusetts and active in the NPI registry since April 2009. The organization lists Agnes W Leung, Chief Financial Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Pine Street Inn At Shattuck is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
116Medicare enrollment records show 116 clinicians reassign Medicare billing to Pine Street Inn At Shattuck, which bills Medicare for the services they deliver. Of these, 112 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 14
Nearest to this location (20)
See all 116Boston, MA 02115
Boston, MA 02118
Boston, MA 02118
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Boston Health Care For The Homeless Program, Inc.'s NPI number?
The NPI number for Boston Health Care For The Homeless Program, Inc. is 1962645572. It was assigned to this organization in the NPPES registry on April 13, 2009. The provider is also known as Pine Street Inn At Shattuck.
Where is Boston Health Care For The Homeless Program, Inc. located?
Boston Health Care For The Homeless Program, Inc. is located at 170 Morton St, Jamaica Plain, MA 02130. The listed phone number is (617) 983-0351.
What is Boston Health Care For The Homeless Program, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Boston Health Care For The Homeless Program, Inc. enrolled in Medicare?
Yes. Boston Health Care For The Homeless Program, Inc. is registered in the Medicare PECOS enrollment system.
When is Boston Health Care For The Homeless Program, Inc.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Massachusetts, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Boston Health Care For The Homeless Program, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 116 clinicians in 14 Medicare specialties reassign their Medicare billing to Boston Health Care For The Homeless Program, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (48), Internal Medicine (24) and Clinical Social Worker (14). Of these, 112 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Boston Health Care For The Homeless Program, Inc. was last updated on May 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Pine Street Inn At Shattuck · NPI 1962645572
Federally Qualified Health Center (FQHC) organization in Jamaica Plain, Massachusetts. Organization record, active in the CMS NPPES registry since April 13, 2009.
## Identity
- **NPI:** 1962645572 (Entity type: Organization)
- **Enumerated:** April 13, 2009
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Boston Health Care For The Homeless Program, Inc.
- **Organization subpart:** No
- **Authorized official:** Agnes Leung, CHIEF FINANCIAL OFFICER
## Practice location
- **Address:** 170 MORTON ST, Jamaica Plain, MA 02130
- **Phone:** (617) 983-0351 · **Fax:** (617) 971-3121
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, Massachusetts, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 116 clinicians in 14 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (48), Internal Medicine (24), Clinical Social Worker (14); 112 practice within 10 miles; [full list](https://npiprofile.com/npi/1962645572/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 23, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1962645572) · Data from the CMS NPPES public registry.