Individual provider Active NPI

Robert J Limoncelli, MSW, LICSW

  • Clinical Social Worker
  • Quincy, MA
National Provider Identifier
1396853560
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103536 Issued in MA
Practice address
22 Spear St
Quincy, MA 02169-4514
Phone
(617) 472-5428
Fax
(617) 847-4450
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
Yes

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
Clinical Social Worker 1041C0700X 103536 MA Primary

Addresses

Primary practice location

22 Spear St
Quincy, MA 02169-4514

Mailing address

22 Spear St
Quincy, MA 02169-4514
Phone (617) 472-5428

Other names 1

  • Mr. Robert J Limoncelli Professional name

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
I20061115000189 MA Practitioner - Clinical Social Worker 0749288371 Practice locations: Quincy, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22 Spear St
Quincy, MA 02169-4514
Phone 61747254282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103536MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396853560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 SPEAR ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694514",
            "telephone_number": "617-472-5428",
            "fax_number": "617-847-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 SPEAR ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694514",
            "telephone_number": "617-472-5428",
            "fax_number": "617-847-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIMONCELLI",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "103536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "LIMONCELLI",
            "middle_name": "J",
            "prefix": "MR.",
            "credential": "MSW, LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.