Individual provider Active NPI

Melinda A Gribko-Reyes, LICSW

  • Clinical Social Worker
  • Bridgewater, MA
National Provider Identifier
1154563013
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111977 Issued in MA
Practice address
90 Fox Hill Dr
Bridgewater, MA 02324-2336
Phone
(781) 510-9863
NPI assigned
Mar 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1957 MA
Clinical Social Worker 1041C0700X 111977 MA Primary

Addresses

Primary practice location

90 Fox Hill Dr
Bridgewater, MA 02324-2336

Mailing address

90 Fox Hill Dr
Bridgewater, MA 02324-2336
Phone (781) 510-9863

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
I20041103000357 MA Practitioner - Clinical Social Worker 4789646530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Management LLPGroup PAC ID 7214974708, 18 clinicians

Practice addresses (Care Compare)

105 Webster St
Suite 8
Hanover, MA 02339-1227
Phone (781) 754-6545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111977MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Insight Inc CurrentSince Apr 25, 2021 Accepting new patients
Pinnacle Health Management, LLP CurrentSince Apr 23, 2009 Accepting new patients
Bay State Community Services, Inc. PastSince Mar 18, 2015 Accepting new patients

Locations

105 Webster St
Ste 8
Hanover, MA 02339
Phone (781) 312-7457

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": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239235200000",
    "number": "1154563013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 FOX HILL DR",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023242336",
            "telephone_number": "781-510-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 FOX HILL DR",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023242336",
            "telephone_number": "781-510-9863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIBKO-REYES",
        "first_name": "MELINDA",
        "middle_name": "A",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "1957",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, MA

Sources for this page

Verify at the official NPI Registry.