Individual provider Active NPI

Rene Schwiesow

  • Mental Health Counselor
  • Randolph, MA
National Provider Identifier
1003181272
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
41 Pacella Park Dr
Randolph, MA 02368-1755
Phone
(781) 440-0400
NPI assigned
Mar 20, 2012
Last updated
Jan 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

41 Pacella Park Dr
Randolph, MA 02368-1755

Mailing address

41 Pacella Park Dr
Randolph, MA 02368-1755
Phone (781) 440-0400

Other identifiers 1

IdentifierTypeStateIssuer
110026265MedicaidMA

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
I20231227002536 MA Practitioner - Mental Health Counselor 5294185682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

30 Taunton GRN
Suite 5
Taunton, MA 02780-3243
Phone (508) 880-6666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1003181272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 PACELLA PARK DR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023681755",
            "telephone_number": "781-440-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 PACELLA PARK DR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023681755",
            "telephone_number": "781-440-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWIESOW",
        "first_name": "RENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110026265",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

Verify at the official NPI Registry.