Pine Street Inn - Men's Clinic – Federally Qualified Health Center (FQHC), NPI 1205080348

Pine Street Inn - Men's Clinic is a healthcare provider. based in Boston, Massachusetts. specializing in Federally Qualified Health Center (FQHC). The organization holds a License No. 4LQX (MA). The NPI Number for Pine Street Inn - Men's Clinic is 1205080348

Main info

Organization
Name
Pine Street Inn - Men's Clinic
NPI
1205080348
Phone
(857) 654-1227
Address
780 ALBANY ST
Authorized Official
AGNES W LEUNG CHIEF FINANCIAL OFFICER
Enumeration Date
14 November 2008
Last Update Date
24 May 2018
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness80
Years active:17State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Pine Street Inn - Men's Clinic

  • Cary W. Akins Pavilion, 780, Albany Street, South End, Boston, Suffolk County, Massachusetts, 02118, United States

    BOSTON, MA 021182755

    Phone: (857) 654-1227

    Fax: (857) 654-1404

    Type: Mailing

  • Pine Street Inn, 444, Harrison Avenue, South End, Boston, Suffolk County, Massachusetts, 02118, United States

    BOSTON, MA 02118

    Phone: (857) 654-1850

    Fax: (857) 654-1433

    Type: Location

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: 2006-08-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
O20060816000296OFederally 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

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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 02118)

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Reviews

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Frequently asked questions

Is Pine Street Inn - Men's Clinic listed with a National Provider Identifier?
Yes — Pine Street Inn - Men's Clinic has NPI 1205080348 on file in the registry.
Is Pine Street Inn - Men's Clinic shown as active in public data?
Registry records indicate Pine Street Inn - Men's Clinic maintains an active NPI.
What area of care is associated with Pine Street Inn - Men's Clinic?
Pine Street Inn - Men's Clinic's record emphasizes Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
Is Pine Street Inn - Men's Clinic located near Boston?
Pine Street Inn - Men's Clinic currently maps to Boston, Massachusetts in this extract.
Can I trust this NPI listing for Pine Street Inn - Men's Clinic?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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