Fenway Health – Federally Qualified Health Center (FQHC), NPI 1003804725

Fenway Health is a healthcare provider. based in Boston, Massachusetts. specializing in Federally Qualified Health Center (FQHC). The organization holds a License No. 4519 (MA). The NPI Number for Fenway Health is 1003804725

Main info

Organization
Name
Fenway Health
NPI
1003804725
Phone
(617) 927-4880
Address
1340 BOYLSTON ST
Authorized Official
JEFF LIEBERMAN VP FINANCE & ADMINISTRATION
Enumeration Date
6 October 2005
Last Update Date
7 July 2011
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Fenway Health

  • Fenway Community Health Center (Ansin Building), 1340, Boylston Street, Audubon Square, Boston, Suffolk County, Massachusetts, 02115, United States

    BOSTON, MA 022154302

    Phone: (617) 927-4880

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-01-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040508000030OClinic/Group PracticeMATBD
O20050126000196OFederally Qualified Health Center (Fqhc)MATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02215)

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Reviews

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Frequently asked questions

Is there an official ID for Fenway Health in U.S. healthcare records?
The official identifier for Fenway Health is NPI 1003804725.
Is Fenway Health shown as active in public data?
Registry records indicate Fenway Health maintains an active NPI.
What area of care is associated with Fenway Health?
Fenway Health's record emphasizes Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
Is Fenway Health located near Boston?
Fenway Health currently maps to Boston, Massachusetts in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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