Active NPI
Jonathan Baum
- Clinical Social Worker
- Allston, MA
National Provider Identifier
1043592470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 118853
- Practice address
- 1304 Commonwealth Ave
Allston, MA 02134-3747 - Phone
- (617) 767-1316
- NPI assigned
- Sep 12, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | 118853 | MA | Primary |
Addresses
Primary practice location
1304 Commonwealth Ave
Allston, MA 02134-3747
Mailing address
1304 Commonwealth Ave
Allston, MA 02134-3747
Phone (617) 767-1316
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
| License | State | Type | Specialty |
|---|---|---|---|
| 118853 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1043592470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1304 COMMONWEALTH AVE",
"city": "ALLSTON",
"state": "MA",
"postal_code": "021343747",
"telephone_number": "617-767-1316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 COMMONWEALTH AVE",
"city": "ALLSTON",
"state": "MA",
"postal_code": "021343747",
"telephone_number": "617-767-1316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUM",
"first_name": "JONATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-12",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "118853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.