Individual provider Active NPI

Peter R Boccardi, LICSW

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1043537640
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC50078663 Issued in DC
Practice address
1350 Pennsylvania Ave. NW
Washington, DC 20004
Phone
(202) 285-9275
NPI assigned
Apr 23, 2010
Last updated
Apr 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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 LC50078663 DC Primary

Addresses

Primary practice location

1350 Pennsylvania Ave. NW
Washington, DC 20004

Mailing address

1350 Pennsylvania Ave. NW
Washington, DC 20004
Phone (202) 285-9275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC50078663DCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1043537640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 PENNSYLVANIA AVE. NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20004",
            "telephone_number": "202-285-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 PENNSYLVANIA AVE. NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20004",
            "telephone_number": "202-285-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCCARDI",
        "first_name": "PETER",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50078663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.