Individual provider Active NPI

Michelle K Keating, LCSW

  • Clinical Social Worker
  • Rio Grande, NJ
National Provider Identifier
1104283639
Registry record updated Mar 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05648500 Issued in NJ
Practice address
1076 RT 47 South
Rio Grande, NJ 08242
Phone
(609) 741-6363
Fax
(609) 939-4450
NPI assigned
Jan 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2022

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 44SC05648500 NJ Primary

Addresses

Primary practice location

1076 RT 47 South
Rio Grande, NJ 08242

Mailing address

1076 RT. 47 South
Rio Grande, NJ 08242
Phone (609) 741-6363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20170307001943 NJ Practitioner - Clinical Social Worker 1759665920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooperative Care Partnership IncGroup PAC ID 8224351606, 5 clinicians

Practice addresses (Care Compare)

1076 Route 47 S
Rio Grande, NJ 08242-1608
Phone (609) 741-6363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperative Care Partnership, Inc CurrentSince Feb 21, 2022 Accepting new patients
Cooperative Care Partnership, Inc. PastSince Feb 21, 2022 Accepting new patients

Locations

1076 Route 47 S
Rio Grande, NJ 08242
Phone (609) 741-6363

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646524800000",
    "number": "1104283639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 RT. 47 SOUTH",
            "city": "RIO GRANDE",
            "state": "NJ",
            "postal_code": "08242",
            "telephone_number": "609-741-6363",
            "fax_number": "609-939-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 RT 47 SOUTH",
            "city": "RIO GRANDE",
            "state": "NJ",
            "postal_code": "08242",
            "telephone_number": "609-741-6363",
            "fax_number": "609-939-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATING",
        "first_name": "MICHELLE",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2022-03-06",
        "certification_date": "2022-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05648500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande, NJ

Sources for this page

Verify at the official NPI Registry.