Individual provider Active NPI

Mary A Coccetti, LCSW

  • Clinical Social Worker
  • Kihei, HI
National Provider Identifier
1033544044
Registry record updated Feb 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3348 Issued in HI
Practice address
411 Huku Lii PL
302
Kihei, HI 96753-7062
Phone
(808) 891-1411
NPI assigned
Sep 9, 2013
Last updated
Feb 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2021

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 3348 HI Primary

Addresses

Primary practice location

411 Huku Lii PL
302
Kihei, HI 96753-7062

Mailing address

2430 S Kihei Rd
Apt 602
Kihei, HI 96753-9672
Phone (808) 879-4191

Other identifiers 1

IdentifierTypeStateIssuer
25903OtherHIHMSA PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20170824000555 HI Practitioner - Clinical Social Worker 4880966944 Practice locations: Kihei, HI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2430 S Kihei Rd
Apt 602
Kihei, HI 96753-9672
Phone (808) 281-0061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3348HIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary a Coccetti, LCSW CurrentSince Feb 14, 2021 Accepting new patients

Networks

  • HI PPO
  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

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": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612569600000",
    "number": "1033544044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 S KIHEI RD",
            "address_2": "APT 602",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967539672",
            "telephone_number": "808-879-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 HUKU LII PL",
            "address_2": "302",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537062",
            "telephone_number": "808-891-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCCETTI",
        "first_name": "MARY",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-09",
        "last_updated": "2021-02-06",
        "certification_date": "2021-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "3348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA PROVIDER #",
            "identifier": "25903",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

Verify at the official NPI Registry.