Individual provider Active NPI

James Siegman, LCSW-C

  • Clinical Social Worker
  • Easton, MD
National Provider Identifier
1033540406
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19045 Issued in MD
Practice address
29446 Hemlock LN
Easton, MD 21601-4885
Phone
(410) 822-5007
Fax
(410) 822-5569
NPI assigned
Dec 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 19045 MD
Clinical Social Worker 1041C0700X 19045 MD Primary

Addresses

Primary practice location

29446 Hemlock LN
Easton, MD 21601-4885

Mailing address

29446 Hemlock LN
Easton, MD 21601-4885
Phone (410) 334-6961

Other identifiers 8

IdentifierTypeStateIssuer
742LOtherMDNOVITAS/MEDICARE
609550002MedicaidMD
346646OtherMDMHN/TRICARE
R968OtherMDCAREFIRST
522156095OtherMDCOMMERCIAL INSURANCE
259147-000OtherMDMAGELLAN BEHAVIORAL HEALTH
7840093OtherMDAETNA
517251OtherMDOPTUM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20161007000283 MD Practitioner - Clinical Social Worker 7810285855 Reassigns benefits to 1 organization
Practice locations: Easton, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peace of Mind Mental Health Services LLCGroup PAC ID 6103047436, 13 clinicians

Practice addresses (Care Compare)

29315 Erickson Dr
Easton, MD 21601-8651
Phone (410) 690-8181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19045MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind Mental Health Services LLC Clinical CurrentSince Oct 18, 2016 Accepting new patients

Locations

29315 Erickson Dr
Easton, MD 21601
Phone (410) 690-8181

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": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1033540406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29446 HEMLOCK LN",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216014885",
            "telephone_number": "410-334-6961",
            "fax_number": "410-334-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29446 HEMLOCK LN",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216014885",
            "telephone_number": "410-822-5007",
            "fax_number": "410-822-5569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGMAN",
        "first_name": "JAMES",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-10",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "19045",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "19045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOVITAS/MEDICARE",
            "identifier": "742L",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609550002",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN/TRICARE",
            "identifier": "346646",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "R968",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCE",
            "identifier": "522156095",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALTH",
            "identifier": "259147-000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7840093",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM",
            "identifier": "517251",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

Verify at the official NPI Registry.