Individual provider Active NPI

Douglas C Riley, M.S.W., L.I.C.S.W.

  • Clinical Social Worker
  • South Dartmouth, MA
National Provider Identifier
1033166376
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
100524 Issued in MA
Practice address
8 Roberta Dr
South Dartmouth, MA 02748-2020
Phone
(508) 992-9376
Fax
(508) 992-9420
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
Yes

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 100524 MA Primary

Addresses

Primary practice location

8 Roberta Dr
South Dartmouth, MA 02748-2020

Mailing address

8 Roberta Dr
South Dartmouth, MA 02748-2020
Phone (508) 992-9376

Other identifiers 8

IdentifierTypeStateIssuer
P01557OtherMAMA BLUE SHIELD
6212763OtherMAUNITED BEHAVIORAL HEALTH
000000022694OtherMABMC HEALTHNET PLAN
008898OtherMAVALUE OPTIONS
SO13145OtherMACHAMPUS/TRICARE
176982OtherMAMAGELLAN BEHAVIORAL HEALT
2081751OtherMACIGNA BEHVIORAL HEALTH
1892193OtherMAMBHP

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
I20050425000827 MA Practitioner - Clinical Social Worker 8224076716 Practice locations: S Dartmouth, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8 Roberta Dr
South Darmouth, MA 02748-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100524MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033166376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 ROBERTA DR",
            "city": "SOUTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027482020",
            "telephone_number": "508-992-9376",
            "fax_number": "508-992-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 ROBERTA DR",
            "city": "SOUTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027482020",
            "telephone_number": "508-992-9376",
            "fax_number": "508-992-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "DOUGLAS",
        "middle_name": "C",
        "credential": "M.S.W., L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "100524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA BLUE SHIELD",
            "identifier": "P01557",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "6212763",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET PLAN",
            "identifier": "000000022694",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "008898",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS/TRICARE",
            "identifier": "SO13145",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALT",
            "identifier": "176982",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHVIORAL HEALTH",
            "identifier": "2081751",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBHP",
            "identifier": "1892193",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Dartmouth, MA

Sources for this page

Verify at the official NPI Registry.