Individual provider Active NPI

Melanie K. Legeros, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1174747216
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113345 Issued in MA
Practice address
1153 Centre St
Dept. of Social Work, Faulkner Hospital
Boston, MA 02130-3446
Phone
(617) 983-7854
Fax
(617) 983-7455
NPI assigned
Apr 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 113345 MA Primary

Addresses

Primary practice location

1153 Centre St
Dept. of Social Work, Faulkner Hospital
Boston, MA 02130-3446

Mailing address

1153 Centre St
Dept. of Social Work, Faulkner Hospital
Boston, MA 02130-3446
Phone (617) 983-7854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20180108002148 VT Practitioner - Clinical Social Worker 0244599736 Practice locations: Barre, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2 N St
Barre, VT 05641-3810
Phone (802) 498-7222

408 Dowsville Rd
South Duxbury, VT 05660-9170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113345MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174747216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 CENTRE ST",
            "address_2": "DEPT. OF SOCIAL WORK, FAULKNER HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021303446",
            "telephone_number": "617-983-7854",
            "fax_number": "617-983-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1153 CENTRE ST",
            "address_2": "DEPT. OF SOCIAL WORK, FAULKNER HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021303446",
            "telephone_number": "617-983-7854",
            "fax_number": "617-983-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGEROS",
        "first_name": "MELANIE",
        "middle_name": "K.",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.