Individual provider Active NPI

Gayle Marie Patrolia, LICSW

  • Social Worker
  • Quincy, MA
National Provider Identifier
1275623217
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1022922 Issued in MA
Practice address
460 Quincy Ave
Quincy, MA 02169-8130
Phone
(617) 689-2569
NPI assigned
Oct 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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
Social Worker 104100000X 1022922 MA Primary

Addresses

Primary practice location

460 Quincy Ave
Quincy, MA 02169-8130

Mailing address

12 Jarvis Ave
Hingham, MA 02043-1312
Phone (781) 740-4639

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
I20050607000027 MA Practitioner - Clinical Social Worker 6507809944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Shore Mental Health Center IncGroup PAC ID 4082508429, 36 clinicians

Practice addresses (Care Compare)

1501 Washington St
Braintree, MA 02184-7599
Phone (617) 847-1950

460 Quincy Ave
Quincy, MA 02169-8130
Phone (617) 847-1950

54 Miller St
Quincy, MA 02169-4725
Phone (617) 847-1950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1022922MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Mental Health Center, Inc. CurrentSince Oct 1, 1995 Accepting new patients
The Therapy Room Associates, LLC Past Accepting new patients

Locations

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

460 Quincy Ave
Quincy, MA 02169
Phone (617) 770-4000

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

Interoperability endpoints

  • Direct secure messaging: gaylepatrolia@ssmh.netsmartdirect.net

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, 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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275623217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 JARVIS AVE",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020431312",
            "telephone_number": "781-740-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 QUINCY AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021698130",
            "telephone_number": "617-689-2569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATROLIA",
        "first_name": "GAYLE",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "1022922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.