Individual provider Active NPI

Kristi Dawn Vargas, LICSW

  • Clinical Social Worker
  • Worcester, MA
National Provider Identifier
1003021940
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1024469 Issued in MA
Practice address
72 Jaques Ave
Worcester, MA 01610-2476
Phone
(508) 860-1295
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1024469 MA Primary

Addresses

Primary practice location

72 Jaques Ave
Worcester, MA 01610-2476

Mailing address

72 Jaques Ave
Worcester, MA 01610-2476
Phone (508) 860-1295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050808000544 MA Practitioner - Clinical Social Worker 9032148374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

600 Worcester Rd
Suite 201
Framingham, MA 01702-5360
Phone (508) 875-1110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince Jun 19, 2024 Accepting new patients

Locations

600 Worcester Rd
Ste 201
Framingham, MA 01702
Phone (508) 875-1110

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003021940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 JAQUES AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102476",
            "telephone_number": "508-860-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 JAQUES AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102476",
            "telephone_number": "508-860-1295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "KRISTI",
        "middle_name": "DAWN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1024469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.