Individual provider Active NPI

Gabriel Gruner, LICSW

  • Clinical Social Worker
  • Brookline, MA
National Provider Identifier
1104013317
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117461 Issued in MA
Practice address
1330 Beacon St
Brookline, MA 02446-3282
Phone
(617) 332-2700
Fax
(617) 277-4752
NPI assigned
Oct 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

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 117461 MA Primary

Addresses

Primary practice location

1330 Beacon St
Brookline, MA 02446-3282

Mailing address

1330 Beacon St
Brookline, MA 02446-3282
Phone (617) 332-2700

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
I20150323000053 MA Practitioner - Clinical Social Worker 3072830587 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
117461MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Apr 16, 2021 Accepting new patients
Brigham & Womens Hospital, Inc. CurrentSince Nov 25, 2013 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients

Locations

221 Longwood Ave
Boston, MA 02115
Phone (617) 732-4918

75 Francis St
Boston, MA 02115

254 2nd Ave
Needham Heights, MA 02494
Phone (781) 416-8414

399 Revolution Dr
Somerville, MA 02145
Phone (800) 856-1983

Interoperability endpoints

  • Direct secure messaging: gruner.gabriel.bwh@direct.partners.masshiway.net

Organizations & group practices 3

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": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1104013317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463282",
            "telephone_number": "617-332-2700",
            "fax_number": "617-277-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463282",
            "telephone_number": "617-332-2700",
            "fax_number": "617-277-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNER",
        "first_name": "GABRIEL",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-02",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.