Individual provider Active NPI

David R Thomas, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1134326812
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1028125 Issued in MA
Practice address
774 Albany St
Boston, MA 02118-3551
Phone
(617) 534-6171
Fax
(857) 288-2240
NPI assigned
Jun 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 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 1028125 MA Primary

Addresses

Primary practice location

774 Albany St
Boston, MA 02118-3551

Mailing address

1010 Massachusetts Ave
Boston, MA 02118-2600
Phone (617) 534-3134

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
I20250307003144 MA Practitioner - Clinical Social Worker 9739600651 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1028125MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince Dec 29, 2024 Accepting new patients
Cambridge Public Health Commission CurrentSince Dec 29, 2024 Accepting new patients
Cambridge Public Health Commission Current Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

350 Main St
Ste 31
Malden, MA 02148
Phone (781) 397-6583

Interoperability endpoints

  • Direct secure messaging: dthomas121968@direct.challiance.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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1134326812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 MASSACHUSETTS AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182600",
            "telephone_number": "617-534-3134",
            "fax_number": "857-288-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183551",
            "telephone_number": "617-534-6171",
            "fax_number": "857-288-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "DAVID",
        "middle_name": "R",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1028125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.