Active NPI
Robert James Boylston III, LICSW
- Clinical Social Worker
- Pittsfield, MA
National Provider Identifier
1093873085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LICSW 107315
- Practice address
- 152 North St
Suite 330
Pittsfield, MA 01201-5149 - Phone
- (413) 443-8480
- Fax
- (413) 443-8455
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LICSW 107315 | MA | Primary |
Addresses
Primary practice location
152 North St
Suite 330
Pittsfield, MA 01201-5149
Mailing address
152 North St
Suite 330
Pittsfield, MA 01201-5149
Phone (413) 443-8480
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BOP06648 | Other | MA | BCBS |
| BOP06648 | Other | MA | EMPIRE |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051202000718 | MA | Practitioner - Clinical Social Worker | 8123048253 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
152 N St
Suite 330
Pittsfield, MA 01201-5118
Phone 41344384801
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LICSW 107315 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert J. Boylston Inc. | Clinical | Current | Accepting new patients |
Locations
152 North St
Ste 330
Pittsfield, MA 01201
Phone (413) 443-8480
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": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093873085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 NORTH ST",
"address_2": "SUITE 330",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012015149",
"telephone_number": "413-443-8480",
"fax_number": "413-443-8455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 NORTH ST",
"address_2": "SUITE 330",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012015149",
"telephone_number": "413-443-8480",
"fax_number": "413-443-8455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYLSTON",
"first_name": "ROBERT",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "LICSW 107315",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "BOP06648",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE",
"identifier": "BOP06648",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pittsfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.