Individual provider Active NPI

Tamara A Martinez, LCSW

  • Clinical Social Worker
  • Willimantic, CT
National Provider Identifier
1316426349
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9665 Issued in CT
Practice address
112 Mansfield Ave
Willimantic, CT 06226-2045
Phone
(860) 465-2350
NPI assigned
Aug 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 9665 CT
Clinical Social Worker 1041C0700X 9665 CT Primary

Addresses

Primary practice location

112 Mansfield Ave
Willimantic, CT 06226-2045

Mailing address

112 Mansfield Ave
Willimantic, CT 06226-2045
Phone (860) 465-2350

Other practice location 1

60 Old Town Rd Unit 196
Vernon, CT 06066-6411
Phone (860) 997-5927

Other names 1

  • Tamara A Bojarski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20180905000295 CT Practitioner - Clinical Social Worker 8729338256 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9665CTMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Oct 2, 2019 Accepting new patients
Windham Community Memorial Hospital, Inc. CurrentSince Jul 21, 2018 Accepting new patients
Hartford Hospital CurrentSince Oct 2, 2019 Accepting new patients
A New Chance, LLC CurrentSince Jun 22, 2021 Accepting new patients
Hartford Pathology Associates, P.C. Current Accepting new patients
Hartford Hospital CurrentSince Oct 2, 2019 Accepting new patients

Locations

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

355 High St
Willimantic, CT 06226
Phone (860) 465-2460

Organizations & group practices 6

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": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1316426349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262045",
            "telephone_number": "860-465-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262045",
            "telephone_number": "860-465-2350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Old Town Rd Unit 196",
            "address_purpose": "LOCATION",
            "city": "Vernon",
            "state": "CT",
            "postal_code": "060666411",
            "country_code": "US",
            "telephone_number": "860-997-5927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "TAMARA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "CT",
            "license": "9665",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "BOJARSKI",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.