Individual provider Active NPI

Paul Anthony Caratazzola

  • Clinical Social Worker
  • Plymouth, MA
National Provider Identifier
1174006670
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1016616 Issued in MA
Practice address
1 Bumps Pond Road
Plymouth, MA 02360
Phone
(508) 291-2441
NPI assigned
Sep 11, 2018
Last updated
Sep 11, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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 1016616 MA Primary

Addresses

Primary practice location

1 Bumps Pond Road
Plymouth, MA 02360

Mailing address

1090 South St
Bridgewater, MA 02324-2960
Phone (774) 222-2896

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
I20250117000111 MA Practitioner - Clinical Social Worker 0244768323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeastern Psychiatric AssocGroup PAC ID 4486696614, 15 clinicians

Practice addresses (Care Compare)

1093 N Main St
Suite 1B
Randolph, MA 02368-2100
Phone (781) 963-7775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1016616MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Psychiatric Assoc CurrentSince Nov 1, 2024 Accepting new patients

Locations

1093 N Main St
Ste 1B
Randolph, MA 02368
Phone (781) 963-7775

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1174006670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 SOUTH ST",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023242960",
            "telephone_number": "774-222-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BUMPS POND ROAD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "02360",
            "telephone_number": "508-291-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARATAZZOLA",
        "first_name": "PAUL",
        "middle_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1016616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.