Individual provider Active NPI

Christopher G. O'Rourke, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1093852782
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1029322 Issued in MA
Practice address
185 Bay State Rd
Boston, MA 02215-1506
Phone
(617) 353-3047
Fax
(617) 353-5539
NPI assigned
Jan 31, 2007
Sex
Male
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 1029322 MA Primary

Addresses

Primary practice location

185 Bay State Rd
Boston, MA 02215-1506

Mailing address

238 S Huntington Ave
Unit #12a
Jamaica Plain, MA 02130-4809
Phone (617) 817-3977

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
I20101012000003 MA Practitioner - Clinical Social Worker 3678765492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
May accept Medicare assignment
Group practices
North End Community Health Committee, Inc.Group PAC ID 8224043971, 56 clinicians

Practice addresses (Care Compare)

332 Hanover Sreet
Boston, MA 02113-1901

332 Hanover St
Boston, MA 02113-1901
Phone (617) 643-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1029322MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North End Community Health Committee Inc CurrentSince May 17, 2022 Accepting new patients

Locations

332 Hanover St
Boston, MA 02113
Phone (617) 643-8000

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093852782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 S HUNTINGTON AVE",
            "address_2": "UNIT #12A",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304809",
            "telephone_number": "617-817-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 BAY STATE RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022151506",
            "telephone_number": "617-353-3047",
            "fax_number": "617-353-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'ROURKE",
        "first_name": "CHRISTOPHER",
        "middle_name": "G.",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1029322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.