Individual provider Active NPI

Aidan Lalin Schmidtberger

  • Clinical Social Worker
  • Charlestown, MA
National Provider Identifier
1184241713
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1121014 Issued in MA
Practice address
15 Tufts St
Charlestown, MA 02129-2711
Phone
(857) 238-1181
NPI assigned
Jun 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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 1121014 MA Primary

Addresses

Primary practice location

15 Tufts St
Charlestown, MA 02129-2711

Mailing address

37 Magee St
Cambridge, MA 02139-2915
Phone (908) 328-2350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • 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
I20221114002268 MA Practitioner - Clinical Social Worker 1153799648 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1121014MAMDClinical Social Worker
228139MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North End Community Health Committee Inc CurrentSince Oct 1, 2022 Accepting new patients

Locations

332 Hanover St
Boston, MA 02113
Phone (617) 643-8000

15 Tufts St
Charlestown, MA 02129
Phone (857) 238-1100

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": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1184241713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 MAGEE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021392915",
            "telephone_number": "908-328-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 TUFTS ST",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021292711",
            "telephone_number": "857-238-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDTBERGER",
        "first_name": "AIDAN",
        "middle_name": "LALIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1121014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlestown, MA

Sources for this page

Verify at the official NPI Registry.