Individual provider Active NPI

Alice Zory, LICSW

  • Clinical Social Worker
  • Pawtucket, RI
National Provider Identifier
1366469124
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW00978 Issued in RI
Practice address
727 East Ave
Pawtucket, RI 02860-6185
Phone
(401) 725-6160
Fax
(401) 722-5430
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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 ISW00978 RI Primary

Addresses

Primary practice location

727 East Ave
Pawtucket, RI 02860-6185

Mailing address

10 Davol SQ
Suite 400
Providence, RI 02903-4754
Phone (401) 421-4000

Other identifiers 2

IdentifierTypeStateIssuer
1104847946OtherRITHE PROVIDENCE CENTER NPI
AZ13967MedicaidRI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address azory221077@direct.lifespan.org

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051221000951 RI Practitioner - Clinical Social Worker 8921020603 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians

Practice addresses (Care Compare)

727 E Ave
Pawtucket, RI 02860-6185
Phone (401) 725-6160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW00978RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Community Action, Inc. CurrentSince Nov 10, 2014 Accepting new patients
Coastal Medical Physicians, Inc. Clinical CurrentSince Apr 25, 2021 Accepting new patients
Coastal Medical Physicians, Inc. Clinical CurrentSince Apr 25, 2021 Accepting new patients
Comprehensive Community Action, Inc CurrentSince Nov 10, 2014 Accepting new patients
The Providence Center Past Accepting new patients

Locations

311 Doric Ave
Cranston, RI 02910
Phone (401) 467-9610

1090 Cranston St
Cranston, RI 02920
Phone (401) 467-9610

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

727 East Ave
Pawtucket, RI 02860
Phone (401) 724-6800

Organizations & group practices 5

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1366469124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DAVOL SQ",
            "address_2": "SUITE 400",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034754",
            "telephone_number": "401-421-4000",
            "fax_number": "401-272-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 EAST AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028606185",
            "telephone_number": "401-725-6160",
            "fax_number": "401-722-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZORY",
        "first_name": "ALICE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW00978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE PROVIDENCE CENTER NPI",
            "identifier": "1104847946",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AZ13967",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "azory221077@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "727 East Ave",
            "city": "Pawtucket",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028606185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.