Individual provider Active NPI

Dorothea A Iannuzzi, LICSW

  • Clinical Social Worker
  • Concord, MA
National Provider Identifier
1184796542
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1021070 Issued in MA
Practice address
747 Main St
Concord, MA 01742-3302
Phone
(781) 246-2010
Fax
(781) 246-1448
NPI assigned
Nov 14, 2006
Last updated
Sep 13, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

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 1021070 MA Primary

Addresses

Primary practice location

747 Main St
Concord, MA 01742-3302

Mailing address

747 Main St
Concord, MA 01742-3302
Phone (781) 246-2010

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
I20051129000592 MA Practitioner - Clinical Social Worker 0547280026 Reassigns benefits to 1 organization
Practice locations: Concord, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

747 Main St
Suite 318
Concord, MA 01742-3329
Phone (978) 764-3490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Jan 1, 2021 Accepting new patients
Riverside Community Care Past Accepting new patients
C.Charles Iannuzzi,M.D.,PC PastSince Dec 4, 1978 Accepting new patients
Riverside Community Care, Inc. Past Accepting new patients

Locations

221 Longwood Ave
Boston, MA 02115
Phone (617) 732-4918

75 Francis St
Boston, MA 02115

Organizations & group practices 4

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505260800000",
    "number": "1184796542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 MAIN ST",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017423302",
            "telephone_number": "781-246-2010",
            "fax_number": "781-246-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 MAIN ST",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017423302",
            "telephone_number": "781-246-2010",
            "fax_number": "781-246-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNUZZI",
        "first_name": "DOROTHEA",
        "middle_name": "A",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2017-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1021070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.