Individual provider Active NPI

Michal Jacob-Goldstein

  • Clinical Social Worker
  • Amherst, MA
National Provider Identifier
1255516795
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
107491 Issued in MA
Practice address
400 Amity St
Amherst, MA 01002-2241
Phone
(413) 584-6855
NPI assigned
Jan 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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 107491 MA Primary

Addresses

Primary practice location

400 Amity St
Amherst, MA 01002-2241

Mailing address

400 Amity St
Amherst, MA 01002-2241
Phone (413) 584-6855

Other practice location 1

43 Autumn Ln
Amherst, MA 01002-3374
Phone (413) 687-0983

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
I20050810000062 MA Practitioner - Clinical Social Worker 9931138971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Servicenet IncGroup PAC ID 6901797950, 53 clinicians

Practice addresses (Care Compare)

400 Amity St
Amherst, MA 01002-2241
Phone (413) 549-0095

50 Pleasant St
Northampton, MA 01060-4127
Phone 4135846855221543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Servicenet Inc CurrentSince Apr 1, 2012 Accepting new patients
Servicenet Inc Past Accepting new patients

Locations

400 Amity St
Amherst, MA 01002
Phone (413) 549-0095

21 Olander Dr
Northampton, MA 01060
Phone (413) 442-4003

50 Pleasant St
Northampton, MA 01060
Phone (413) 585-1300

141 North St
Pittsfield, MA 01201
Phone (413) 442-4003

Organizations & group practices 2

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": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1255516795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 AMITY ST",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022241",
            "telephone_number": "413-584-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AMITY ST",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022241",
            "telephone_number": "413-584-6855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43 Autumn Ln",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "MA",
            "postal_code": "010023374",
            "country_code": "US",
            "telephone_number": "413-687-0983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB-GOLDSTEIN",
        "first_name": "MICHAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-03",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "107491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, MA

Sources for this page

Verify at the official NPI Registry.