Provider Demographics
NPI:1821095779
Name:PLANNED PARENTHOOD LEAGUE OF MASSACHUSETTS, INC.
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD LEAGUE OF MASSACHUSETTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-616-1684
Mailing Address - Street 1:1055 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-1001
Mailing Address - Country:US
Mailing Address - Phone:617-616-1600
Mailing Address - Fax:617-616-1603
Practice Address - Street 1:1055 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1001
Practice Address - Country:US
Practice Address - Phone:617-616-1600
Practice Address - Fax:617-616-1603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA440261QA0005X
MA0055170261QA0005X
MA2241367332900000X
MA2241343332900000X
MA2241355332900000X
MA2241379332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0006921OtherNEIGHBORHOOD HEALTH PLAN
MA1305743Medicaid
MA1606042Medicaid
MA0225936A01OtherBMC HEALTHNET
MA996152OtherNETWORK HEALTH
MAM17121OtherBLUE CROSS
MA601393OtherHARVRAD PILGRIM
MA5038048OtherCIGNA
MA706078OtherTUFTS HEALTH PLAN
MA1600532Medicaid
MA538876OtherAETNA
MA1161198OtherFIRST HEALTH
MA0701295OtherUNITED HEALTH CARE
MA23905OtherHEALTH NEW ENGLAND