Individual provider Active NPI

Robert Jame Remillard Jr., LICSW

  • Clinical Social Worker
  • Plymouth, MA
National Provider Identifier
1215011622
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1018307 Issued in MA
Practice address
59 Samoset St
Plymouth, MA 02360-4551
Phone
(508) 934-9228
NPI assigned
Oct 24, 2006
Sex
Male
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 1018307 MA Primary

Addresses

Primary practice location

59 Samoset St
Plymouth, MA 02360-4551

Mailing address

114 Strathmore Rd
Brighton, MA 02135-7119
Phone (508) 934-9228

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
I20051110000327 MA Practitioner - Clinical Social Worker 1052339751 Reassigns benefits to 1 organization
Practice locations: Plymouth, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

139 Court St
Plymouth, MA 02360-8711
Phone (508) 934-9228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Mental Health Center, Inc. CurrentSince Jan 1, 1990 Accepting new patients

Locations

1501 Washington St
Braintree, MA 02184
Phone (617) 745-2709

500 Victory Rd
Quincy, MA 02171
Phone (617) 774-1040

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215011622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 STRATHMORE RD",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021357119",
            "telephone_number": "508-934-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 SAMOSET ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604551",
            "telephone_number": "508-934-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMILLARD",
        "first_name": "ROBERT",
        "middle_name": "JAME",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1018307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.