Fenway South End – Community Health Clinic/Center, NPI 1982995197

Fenway South End is a healthcare provider. based in Boston, Massachusetts. specializing in Community Health Clinic/Center. The organization holds a License No. 4519 (MA). The NPI Number for Fenway South End is 1982995197

Main info

Organization
Name
Fenway South End
NPI
1982995197
Phone
(617) 927-6073
Address
1340 BOYLSTON ST
Authorized Official
MR. JEFFREY M LIEBERMAN VP FINANCE & ADMINISTRATION
Enumeration Date
21 April 2011
Last Update Date
8 July 2011
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness80
Years active:15State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for Fenway South End

  • 1340 BOYLSTON ST

    BOSTON, MA 022154302

    Phone: (617) 927-6073

    Fax: (617) 927-5410

    Type: Mailing

  • 142 BERKELEY ST

    BOSTON, MA 021165100

    Phone: (617) 247-7555

    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: 2011-07-11

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
O20110711000045OFederally 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

How do I look up Fenway South End by NPI?
Use NPI 1982995197 when you need to reference Fenway South End in forms, claims, or directories.
Is Fenway South End active in the national directory?
Fenway South End's public NPI profile is in an active state.
What field does Fenway South End work in?
You can think of Fenway South End as practicing within Community Health Clinic/Center. Clinical services aligned with this taxonomy classification.
Where is Fenway South End's primary listing?
We display Boston, Massachusetts because that is what the record indicates for Fenway South End.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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