Covered Entity Details

DSH220116K TUFTS MEDICAL CENTER (Active) - information as of 5/3/2025 11:29:06 PM

Main Details

Name

TUFTS MEDICAL CENTER

Subdivision Name

TUFTS MEDICAL CENTER FRAMINGHAM - Infusion Center

Type

Disproportionate Share Hospital

Rural

340B ID

DSH220116K

Medicare Provider Number

220116

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

4/1/2024

Participating Start Date

7/1/2024

Participating Approval Date

4/9/2024

Last Recertification Date

8/13/2024

Contacts

Authorizing Official

Tufts Medical Center
kevin michael bennett, SVP, Finance
(617) 636-2533

Primary Contact

Tufts Medical Center
Joan Marie Calamari, Director of Pharmacy
(617) 877-0552

Addresses

Street Address

99 LINCOLN ST
FRAMINGHAM, MA 01702-6327

Billing Address

Tufts Medical Center
800 Washington Street
Boston, MA 02111

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
MA	110020611G,110020611D	1730132515,1053350306,1851337141,1508948613
RI	OP20116,0220116	1730132515,1053350306,1851337141,1508948613
CT	003079789,003032570	1730132515,1053350306,1851337141,1508948613
VT	0220116	1730132515,1053350306,1851337141,1508948613
NH	3071222	1730132515,1053350306,1851337141,1508948613
NY	01608240	1730132515,1053350306,1851337141,1508948613
ME		1730132515,1053350306,1851337141,1508948613

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH220116A	Child	DSH	TUFTS MEDICAL CENTER	South Boston Day Hospital	58 Old Colony Ave	South Boston	MA	Terminated
DSH220116B	Child	DSH	TUFTS MEDICAL CENTER	Kidney and Blood Pressure Clinic	35 Kneeland Street	BOSTON	MA	Active
DSH220116C	Child	DSH	TUFTS MEDICAL CENTER	TUFTS MEDICAL CENTER CANCER CENTER - Hematology / Oncology Clinic	41 MONTVALE AVE	STONEHAM	MA	Active
DSH220116D	Child	DSH	TUFTS MEDICAL CENTER	TUFTS MEDICAL CENTER, INC - Tufts Medical Center Cancer Center - Infusion Center	41 MONTVALE AVE	STONEHAM	MA	Active
DSH220116E	Child	DSH	TUFTS MEDICAL CENTER	Tufts Medical Center (Neurology - Medford) - Neurology	170 Governors Ave	Medford	MA	Active
DSH220116F	Child	DSH	TUFTS MEDICAL CENTER	Tufts Medical Center Gastrointestinal Stoneham - Gastrointestinal	51 Montvale Ave	Stoneham	MA	Active
DSH220116G	Child	DSH	TUFTS MEDICAL CENTER	Tufts Medical Center Rheumatology Reading - Rheumatology	30 New Crossing Road	Reading	MA	Active
DSH220116H	Child	DSH	TUFTS MEDICAL CENTER	Tufts Medical Center (Endocrine / Diabetes - Medford) - Endocrine, Diabetes	170 Governors Ave	Medford	MA	Active
DSH220116J	Child	DSH	TUFTS MEDICAL CENTER	Tufts Medical Center (Endocrine/Diabetes) - Melrose - Endocrine/Diabetes	585 Lebanon Street	Melrose	MA	Active
DSH220116K	Child	DSH	TUFTS MEDICAL CENTER	TUFTS MEDICAL CENTER FRAMINGHAM - Infusion Center	99 LINCOLN ST	FRAMINGHAM	MA	Active
DSH220116L	Child	DSH	TUFTS MEDICAL CENTER	TUFTS MEDICAL CENTER FRAMINGHAM - Hematology / Oncology Clinic	99 LINCOLN ST	FRAMINGHAM	MA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification		8/13/2024 8:21:58 AM	8/13/2024 8:21 AM
Contacts	Authorizing Official	Update	AO Change Request	Siddiqi, Assad Senior Vice President of Finance Tufts Medical Center 6176367767	bennett, kevin michael SVP, Finance Tufts Medical Center 6176362533	8/12/2024 4:44 PM
Details	State	Update		Approved	Active	7/1/2024 12:01 AM
Contacts	Signed By	Insert	New Registration		Siddiqi, Assad Senior Vice President of Finance Tufts Medical Center 6176367767	4/9/2024 1:16 PM
Details	340B ID	Update	New Registration		DSH220116K	4/9/2024 1:16 PM
Details	Entity Subname	Update	New Registration	TUFTS MEDICAL CENTER FRAMINGHAM	TUFTS MEDICAL CENTER FRAMINGHAM - Infusion Center	4/9/2024 1:16 PM
Dates	Participating Approval Date	Update	New Registration		4/9/2024 1:16:48 PM	4/9/2024 1:16 PM
Details	State	Update	New Registration	Pending	Approved	4/9/2024 1:16 PM
Dates	Signed By Date	Update	New Registration		4/3/2024 12:29:05 PM	4/9/2024 1:16 PM
Dates	Start Date	Update	New Registration		7/1/2024 12:00:00 AM	4/9/2024 1:16 PM
Addresses	Main Address	Insert	New Registration		99 LINCOLN ST FRAMINGHAM, MA 01702-6327	4/1/2024 2:15 PM
Addresses	Billing Address	Insert	New Registration		Tufts Medical Center 800 Washington Street Boston, MA 02111	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		110020611G	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		MA	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		110020611D	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		MA	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		OP20116	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		RI	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		0220116	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		RI	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		003079789	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		CT	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		003032570	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		CT	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		0220116	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		VT	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		3071222	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NH	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		01608240	4/1/2024 2:15 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1730132515	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		MA	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1053350306	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		MA	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1851337141	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		MA	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1508948613	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		MA	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1730132515	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		RI	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1053350306	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		RI	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1851337141	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		RI	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1508948613	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		RI	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1730132515	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		CT	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1053350306	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		CT	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1851337141	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		CT	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1508948613	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		CT	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1730132515	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		VT	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1053350306	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		VT	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1851337141	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		VT	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1508948613	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		VT	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1730132515	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		NH	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1053350306	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		NH	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1851337141	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		NH	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1508948613	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		NH	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1730132515	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1053350306	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1851337141	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1508948613	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1730132515	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		ME	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1053350306	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		ME	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1851337141	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		ME	4/1/2024 2:15 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1508948613	4/1/2024 2:15 PM
Medicaid Billing	NPI: State	Insert	New Registration		ME	4/1/2024 2:15 PM
Contacts	Authorizing Official	Insert	New Registration		Siddiqi, Assad Senior Vice President of Finance Tufts Medical Center 6176367767	4/1/2024 2:15 PM
Contacts	Primary Contact	Insert	New Registration		Calamari, Joan Marie Director of Pharmacy Tufts Medical Center 6178770552	4/1/2024 2:15 PM
Details	Assistance Received From Date	Insert	New Registration			4/1/2024 2:15 PM
Details	Assistance Received To Date	Insert	New Registration			4/1/2024 2:15 PM
Details	Last Recertification Date	Insert	New Registration			4/1/2024 2:15 PM
Details	Grant Number	Insert	New Registration			4/1/2024 2:15 PM
Details	340B ID	Insert	New Registration			4/1/2024 2:15 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/1/2024 2:15 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/1/2024 2:15 PM
Details	Medicare Provider Number	Insert	New Registration		220116	4/1/2024 2:15 PM
Details	Entity Name	Insert	New Registration		TUFTS MEDICAL CENTER	4/1/2024 2:15 PM
Details	NOFO Number	Insert	New Registration			4/1/2024 2:15 PM
Details	Program Code	Insert	New Registration		DSH	4/1/2024 2:15 PM
Details	Entity Subname	Insert	New Registration		TUFTS MEDICAL CENTER FRAMINGHAM	4/1/2024 2:15 PM
Dates	Participating Approval Date	Insert	New Registration			4/1/2024 2:15 PM
Details	State	Insert	New Registration		Pending	4/1/2024 2:15 PM
Dates	Registration Date	Insert	New Registration		4/1/2024 2:15:53 PM	4/1/2024 2:15 PM
Dates	Signed By Date	Insert	New Registration			4/1/2024 2:15 PM
Dates	Start Date	Insert	New Registration			4/1/2024 2:15 PM
Terminations	Termination Comments	Insert	New Registration			4/1/2024 2:15 PM
Terminations	Termination Date	Insert	New Registration			4/1/2024 2:15 PM
Terminations	Termination Effective Date	Insert	New Registration			4/1/2024 2:15 PM
Terminations	Termination Reason	Insert	New Registration			4/1/2024 2:15 PM