Individual provider Active NPI

Jennifer G. Padre, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1043749054
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
120318 Issued in MA
Practice address
1 Boston Medical Center Place
Boston, MA 02118
Phone
(617) 414-5245
Fax
(617) 414-5520
NPI assigned
Jun 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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 120318 MA Primary

Addresses

Primary practice location

1 Boston Medical Center Place
Boston, MA 02118

Mailing address

801 Albany St
FL G
Boston, MA 02119

Other practice location 1

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8000

Other identifiers 1

IdentifierTypeStateIssuer
110148732AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Opted out of Medicare
Yes, effective May 21, 2026 through May 21, 2028

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210211000721 MA Practitioner - Clinical Social Worker 1557776218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
120318MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc CurrentSince Jul 10, 2024 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

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": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1043749054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY ST",
            "address_2": "FL G",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CENTER PLACE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-5245",
            "fax_number": "617-414-5520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018050001",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADRE",
        "first_name": "JENNIFER",
        "middle_name": "G.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "120318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110148732A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.