Individual provider Active NPI

John Augustus Northridge, LICSW

  • Clinical Social Worker
  • South Boston, MA
National Provider Identifier
1174586168
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105237 Issued in MA
Practice address
58 Old Colony Ave
South Boston, MA 02127-2406
Phone
(617) 268-1700
Fax
(617) 268-1991
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 105237 MA Primary

Addresses

Primary practice location

58 Old Colony Ave
South Boston, MA 02127-2406

Mailing address

11 Orchard Rd
Weymouth, MA 02190-1636
Phone (781) 335-6104

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
I20050315000978 MA Practitioner - Clinical Social Worker 1658326343 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health and Human Services LLCGroup PAC ID 8729311840, 10 clinicians

Practice addresses (Care Compare)

76 Beech St
Norwood, MA 02062-2047
Phone (781) 242-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105237MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Human Services, LLC CurrentSince Feb 11, 2022 Accepting new patients
Tufts Medical Center, Inc. CurrentSince Aug 1, 1999 Accepting new patients
Tufts Medical Center, Inc. CurrentSince Aug 1, 1999 Accepting new patients

Locations

750 Washington St
#833
Boston, MA 02111
Phone (617) 636-4800

750 Washington St
#1005
Boston, MA 02111
Phone (617) 636-4660

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

750 Washington St
Boston, MA 02111
Phone (617) 636-4600

58 Old Colony Ave
South Boston, MA 02127
Phone (617) 268-1700

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, 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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174586168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ORCHARD RD",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021901636",
            "telephone_number": "781-335-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 OLD COLONY AVE",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272406",
            "telephone_number": "617-268-1700",
            "fax_number": "617-268-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHRIDGE",
        "first_name": "JOHN",
        "middle_name": "AUGUSTUS",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "105237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, MA

Sources for this page

Verify at the official NPI Registry.