Individual provider Active NPI

Amy Katharine Vaccaro, MSS LCSW

  • Clinical Social Worker
  • Media, PA
National Provider Identifier
1164516118
Registry record updated Aug 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW014201 Issued in PA
Practice address
205 N. Monroe St.
Media, PA 19063
Phone
(610) 566-3484
Fax
(610) 672-9814
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2012

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 CW014201 PA Primary

Addresses

Primary practice location

205 N. Monroe St.
Media, PA 19063

Mailing address

205 N Monroe St
Media, PA 19063-3052
Phone (610) 566-3484

Other identifiers 1

IdentifierTypeStateIssuer
101791815MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20130730000176 PA Practitioner - Clinical Social Worker 9133360431 Reassigns benefits to 1 organization
Practice locations: Media, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Delaware County Professional Services, IncGroup PAC ID 2668436692, 276 clinicians

Practice addresses (Care Compare)

1055 E Baltimore Pike
Media, PA 19063-5173
Phone (610) 892-3800

780 E Market St
West Chester, PA 19382-4882
Phone (610) 892-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware County Professional Services, Inc CurrentSince Feb 14, 2019 Accepting new patients

Locations

1055 E Baltimore Pike
Ste 303
Media, PA 19063
Phone (267) 807-3169

1055 E Baltimore Pike
Ste 301
Media, PA 19063
Phone (267) 223-7802

1055 E Baltimore Pike
Ste 300
Media, PA 19063
Phone (253) 346-0020

19 Campus Blvd
Ste 102
Newtown Square, PA 19073
Phone (610) 356-2100

780 E Market St
West Chester, PA 19382
Phone (425) 908-0237

780 E Market St
Ste 220
West Chester, PA 19382

780 E Market St
Ste 230
West Chester, PA 19382
Phone (484) 468-1412

Interoperability endpoints

  • Direct secure messaging: dcp.amyvaccaro@141748.advancedmd-direct.com

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345161600000",
    "number": "1164516118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N MONROE ST",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633052",
            "telephone_number": "610-566-3484",
            "fax_number": "610-672-9814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N. MONROE ST.",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "19063",
            "telephone_number": "610-566-3484",
            "fax_number": "610-672-9814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCARO",
        "first_name": "AMY",
        "middle_name": "KATHARINE",
        "name_prefix": "Ms.",
        "credential": "MSS LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101791815",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.