Individual provider Active NPI

Kevin Vincent Masturzo, LCSW

  • Clinical Social Worker
  • Palm Bay, FL
National Provider Identifier
1073636775
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14520 Issued in FL
Practice address
4031 Dixie Hwy NE
Palm Bay, FL 32905-3682
Phone
(321) 622-3222
NPI assigned
Apr 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X CW015626 PA
Clinical Social Worker 1041C0700X SW14520 FL Primary

Addresses

Primary practice location

4031 Dixie Hwy NE
Palm Bay, FL 32905-3682

Mailing address

184 Galveston St SW
Palm Bay, FL 32908-7138
Phone (215) 264-3755

Other practice location 1

110 Washington Ave
North Wales, PA 19454-3425
Phone (215) 264-3755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070423000305 PA Practitioner - Clinical Social Worker 8527163336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychology and Counseling Associates, PCGroup PAC ID 9335127067, 40 clinicians

Practice addresses (Care Compare)

2091 E High St
Pottstown, PA 19464-3211
Phone (610) 970-5234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology & Counseling Associates, PC CurrentSince Apr 1, 2014 Accepting new patients

Locations

555 Second Ave
Ste G120
Collegeville, PA 19426
Phone (610) 489-6240

2091 E High St
Pottstown, PA 19464
Phone (610) 970-5234

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1073636775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 GALVESTON ST SW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329087138",
            "telephone_number": "215-264-3755",
            "fax_number": "267-219-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4031 DIXIE HWY NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329053682",
            "telephone_number": "321-622-3222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "North Wales",
            "state": "PA",
            "postal_code": "194543425",
            "country_code": "US",
            "telephone_number": "215-264-3755",
            "fax_number": "215-699-6677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTURZO",
        "first_name": "KEVIN",
        "middle_name": "VINCENT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2022-07-21",
        "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": "PA",
            "license": "CW015626",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.