PINE STREET INN AT SHATTUCK
NPI 1962645572
Clinic/Center - Federally Qualified Health Center (FQHC) in Jamaica Plain, MA
NPI Status: Active since April 13, 2009
Contact Information
170 MORTON ST
JAMAICA PLAIN, MA
ZIP 02130
Phone: (617) 983-0351
Fax: (617) 971-3121
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- CLIA Number: 22D0974805
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 06-15-2026
About PINE STREET INN AT SHATTUCK
This page provides the complete NPI Profile along with additional information for Pine Street Inn At Shattuck, a primary care provider established in Jamaica Plain, Massachusetts operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1962645572 assigned on April 2009. The practitioner's primary taxonomy code is 261QF0400X with license number 4LQX (MA). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's other name is Pine Street Inn At Shattuck. The authorized official of this NPI record is Agnes W Leung (Chief Financial Officer)
- NPI
- 1962645572
- Provider Legal Name
- BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM, INC.
- Other Organization Name
- PINE STREET INN AT SHATTUCK
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 170 MORTON ST JAMAICA PLAIN, MA 02130
- Location Phone
- (617) 983-0351
- Location Fax
- (617) 971-3121
- Mailing Address
- 780 ALBANY ST BOSTON, MA 02118
- Mailing Phone
- (857) 654-1227
- Mailing Fax
- (617) 971-3121
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-13-2009
- Last Update Date
- 05-23-2018
- Code Navigator
A primary care provider (PCP) like Pine Street Inn At Shattuck sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Federally Qualified Health Center (FQHC)
- Taxonomy Code
- 261QF0400X
- Type
- Ambulatory Health Care Facilities
- License No.
- 4LQX
- License State
- MA
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 22D0974805
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- June 16, 2024
- Certificate Expiration Date
- June 15, 2026
- Laboratory Director
- JESSIE M. GAETA
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Pine Street Inn At Shattuck in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
Reviews for PINE STREET INN AT SHATTUCK
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1962645572, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
JAMAICA PLAIN, MA 02130
JAMAICA PLAIN, MA 02130
JAMAICA PLAIN, MA 02130
JAMAICA PLAIN, MA 02130
JAMAICA PLAIN, MA 02130
BOSTON, MA 02130
JAMAICA PLAIN, MA 02130
BOSTON, MA 02130
JAMAICA PLAIN, MA 02130
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1962645572, enumerated as an "organization" on April 13, 2009.
The provider is located at 170 MORTON ST JAMAICA PLAIN, MA 02130 and the phone number is (617) 983-0351.
Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).
