Active NPI
Anthony John Palombo Jr.
- Clinical Social Worker
- Brockton, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW03403
- Practice address
- 1115 W Chestnut St
Brockton, MA 02301-7501 - Phone
- (508) 580-4691
- NPI assigned
- May 16, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | ISW03403 | RI | Primary |
Addresses
Primary practice location
1115 W Chestnut St
Brockton, MA 02301-7501
Mailing address
1115 W Chestnut St
Brockton, MA 02301-7501
Phone (508) 580-4691
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1443 Hartford Ave
Johnston, RI 02919-3224
Phone (401) 273-8100
Hospital & facility affiliations
- South County Hospital Inc
- Westerly Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gateway Healthcare Inc | Current | Accepting new patients |
Locations
1516 Atwood Ave
Johnston, RI 02919
Phone (401) 463-8829
117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318
1443 Hartford Ave
Providence, RI 02919
Phone (401) 273-8100
1 Virginia Ave
Ste 200
Providence, RI 02905
593 Eddy St
Providence, RI 02903
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Pawtucket, RI
- NPI 1821078932
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Westerly, RI
- NPI 1447595368
-
- General Acute Care Hospital
- Wakefield, RI
- NPI 1952366106
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638921600000",
"number": "1235575259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 W CHESTNUT ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023017501",
"telephone_number": "508-580-4691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 W CHESTNUT ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023017501",
"telephone_number": "508-580-4691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALOMBO",
"first_name": "ANTHONY",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-16",
"last_updated": "2021-12-08",
"certification_date": "2021-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW03403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.