Anthony Medaro, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS11369 Issued in CA

Practice address

3880 S Bascom Ave
Suite 212
San Jose, CA 95124-2674

Phone

(408) 377-7099

Fax

(408) 377-7833

NPI assigned

Feb 21, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Social Worker

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Halcyon Group, LLC

  dba Bay Area Psychotherapy Group

  • Community/Behavioral Health Agency
  • Oakland, CA
  • NPI 1396155081
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033254412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE",
            "address_2": "SUITE 212",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242674",
            "telephone_number": "408-377-7099",
            "fax_number": "408-377-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE",
            "address_2": "SUITE 212",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242674",
            "telephone_number": "408-377-7099",
            "fax_number": "408-377-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDARO",
        "first_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS11369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Mecca
• Victor Jose Arevalo Meceda, M.D.
• Med Axis Revenue Services LLC
• Med Bridge Billing Services LLC
• Kenia Medal
• Marlene Medel, ACSW 85813
• Medella Five Elements
• Uriel Ulises Mederos Vazquez
• Medex HM Pharmacy
• Medical Marts of California Inc

• Clinical Social Worker in San Jose, CA
• Providers in San Jose, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.