Kimberly D Percival, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

111838 Issued in MA

Practice address

64 Eldredge St
Newton, MA 02458-2017

Phone

(617) 969-4925

Fax

(617) 244-2507

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riverside Community Care IncGroup PAC ID 6709799885, 117 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Riverside Community Care, Inc.

  • Community/Behavioral Health Agency
  • Norwood, MA
  • NPI 1780791467
  Medicare reassignment Care Compare group NPD
• Riverside Community Care

  • Community/Behavioral Health Agency
  • Dedham, MA
  • NPI 1386195030
  NPD (past)
• Riverside Community Care

  • Community/Behavioral Health Agency
  • Newton, MA
  • NPI 1730473992
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306906847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 ELDREDGE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582017",
            "telephone_number": "617-969-4925",
            "fax_number": "617-244-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 ELDREDGE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582017",
            "telephone_number": "617-969-4925",
            "fax_number": "617-244-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERCIVAL",
        "first_name": "KIMBERLY",
        "middle_name": "D",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marlena Pelliccio, PT
• Allison Pendleton
• Teron Peoples
• Peoplesdental, P.C.
• Kiana Peralta
• Nicole Perdomo
• Isabel Laine Peredy, OT, OTD, OTR
• Francis Perez
• Isabella Perez
• Johnathan Winston Perez

• Clinical Social Worker in Newton, MA
• Providers in Newton, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.