Codman Square Health Center · Community Health Clinic/Center

42 Highland Avenue, Randolph, MA 02368-0000

Overview

Codman Square Health Center is a Community Health Clinic/Center (organization) practicing in Randolph, Massachusetts. The National Provider Identifier (NPI) is #1003770736, which was assigned on December 16, 2025, and the registration record was last updated on December 16, 2025. The practitioner's main practice location is at 42 Highland Avenue, Randolph, MA 02368-0000; the contact telephone number is 6178259660, and the fax number is 6172887898. The primary taxonomy of Codman Square Health Center is Community Health Clinic/Center (261QC1500X), with specialization in Community Health. The authorized official for Codman Square Health Center is Guy Fish (Ceo).

Provider Information

NPI 1003770736
Entity Type Organization
Organization Name CODMAN SQUARE HEALTH CENTER
Provider Name CODMAN SQUARE HEALTH CENTER
Practice Address 42 Highland Avenue
Randolph
MA 02368-0000
Practice Telephone 6178259660
Practice Fax Number 6172887898
Mailing Address 637 Washington St
Dorchester
MA 02124-3510
Mailing Telephone 6178259660
Mailing Fax Number 6172887898
Certification Date 2025-12-15
Enumeration Date 2025-12-16
Last Update Date 2025-12-16
Is Organization Subpart N

Authorized Official Information

Official Name GUY FISH
Official Title CEO
Telephone 6178259660

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y261QC1500XClinic/CenterCommunity Health

Taxonomy Information

Primary Taxonomy

Code 261QC1500X
Taxonomy Community Health Clinic/Center
Classification Clinic/Center
Specialization Community Health
Grouping Ambulatory Health Care Facilities
Definition: Definition to come...

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Location Information

Street Address 42 HIGHLAND AVENUE
City RANDOLPH
State MA
Zip Code 02368-0000
Country US

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Michael Thomas Quinn 14 Pacella Park Dr., May Institute, Randolph, MA 02368-0000Mental Health Counselor2013-08-13

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Katie Nguyen 44 Diauto Drive, Randolph, MA 02368Student in an Organized Health Care Education/Training Program2016-08-28
Chika Patience Okerekw-Nwankwo 22 Marion Street, Randolph, MA 02368Adult Care Home Facility2015-02-16
Randolph Smiles LLC 56 South Main Street, Randolph, MA 02368Dentist2016-11-08
Ashley Lauren Davis 11 Mcdonnell Drive, Randolph, MA 02368Licensed Practical Nurse2018-07-11
Julie A Panchamsingh-Barakat · Julie A Ali 400-, 402 N Main St, Randolph, MA 02368Clinical Social Worker2016-06-08
Daniel Joseph Bellistri Daniel Bellistri, 70 Memorial Pkwy., Randolph, MA 02368Clinical Social Worker2019-04-26
Mara E Power 41 Pacella Park Drive, Randolph, MA 02368Behavior Technician2024-05-23
Codman Eye Care Affiliates -South Shore Inc 9 Warren St, Randolph, MA 02368Optometrist2018-05-08
Heavenly Home Care 9 William Morrison Drive, Randolph, MA 02368Home Health Agency2016-02-24
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.