Upham's Corner Health Center – Community Health Clinic/Center, NPI 1780780486

Upham's Corner Health Center is a healthcare provider. based in Dorchester, Massachusetts. specializing in Community Health Clinic/Center. The organization holds a License No. 490 (MA). The NPI Number for Upham's Corner Health Center is 1780780486

Main info

Organization
Name
Upham's Corner Health Center
NPI
1780780486
Phone
(617) 287-8000
Address
500 COLUMBIA RD
Authorized Official
MR. JAGDEEP TRIVEDI CEO
Enumeration Date
16 September 2006
Last Update Date
12 July 2017
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Upham's Corner Health Center

  • Columbia Road, Mount Bowdoin, Dorchester, Boston, Suffolk County, Massachusetts, 02121, United States

    DORCHESTER, MA 021252322

    Phone: (617) 287-8000

    Fax: (617) 282-8625

    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: 2015-11-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-06-30 (709 days ago).

Enrollment records

4

Earliest due date

2024-06-30

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
O20060508000841OClinic/Group PracticeMA2024-06-30
O20100426000035OFederally Qualified Health Center (Fqhc)MATBD
O20151118001892OFederally Qualified Health Center (Fqhc)MA2025-06-30
O20151118002748OFederally Qualified Health Center (Fqhc)MATBD

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 02125)

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Reviews

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Frequently asked questions

Can I verify Upham's Corner Health Center with an NPI only?
You can start verification with NPI 1780780486 for Upham's Corner Health Center, then check state licensing separately.
Is Upham's Corner Health Center listed as active for patients and plans?
The listing shows Upham's Corner Health Center as active in the NPI system.
What healthcare role does Upham's Corner Health Center hold?
Scheduling teams often label Upham's Corner Health Center under Community Health Clinic/Center. Clinical services aligned with this taxonomy classification.
Where should I expect Upham's Corner Health Center on a map?
Expect Dorchester, Massachusetts as a primary anchor for Upham's Corner Health Center unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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