Individual provider Active NPI

Ruth Ellen Levy, LICSW

  • Clinical Social Worker
  • Watertown, MA
National Provider Identifier
1083769673
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1020927 Issued in MA
Practice address
64 Evans St
Watertown, MA 02472-2150
Phone
(617) 926-3946
NPI assigned
Jan 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1020927 MA Primary

Addresses

Primary practice location

64 Evans St
Watertown, MA 02472-2150

Mailing address

64 Evans St
Watertown, MA 02472-2150
Phone (617) 926-3946

Other identifiers 1

IdentifierTypeStateIssuer
1020927OtherMASOCIAL WORK LICENSE NUMBE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040519000051 MA Practitioner - Clinical Social Worker 9931190022 Reassigns benefits to 1 organization
Practice locations: Amherst, MA

Care Compare profile

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

Practice addresses (Care Compare)

375 Pelham Rd
Amherst, MA 01002-1654
Phone (617) 372-1721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1020927MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Wing Hospital Corporation CurrentSince Jul 26, 2011 Accepting new patients
Baystate Wing Hospital Corporation CurrentSince Jul 26, 2011 Accepting new patients

Locations

40 Wright St
Palmer, MA 01069
Phone (413) 284-5210

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

Organizations & group practices 2

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083769673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 EVANS ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722150",
            "telephone_number": "617-926-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 EVANS ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722150",
            "telephone_number": "617-926-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "RUTH",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1020927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE NUMBE",
            "identifier": "1020927",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

Verify at the official NPI Registry.