Emily Medina, LICSW, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

121522 Issued in MA

Practice address

3 Baldwin Green CMN Ste 393
Woburn, MA 01801-1865

Phone

(781) 771-9789

NPI assigned

Oct 27, 2018

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

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.

• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment NPD

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

{
    "created_epoch": "1540598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540598400000",
    "number": "1477020469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HIGH ROCK LN",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "020901038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BALDWIN GREEN CMN STE 393",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011865",
            "telephone_number": "781-771-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "EMILY",
        "credential": "LICSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-27",
        "last_updated": "2018-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "121522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gail McPherson, PTA
• Casey Louise McVicar, PT, DPT, CBIS
• Medallion Transportation Inc
• Medequip Services, Inc.
• Medilotus Acupuncture and Herbs LLC
• Loly Michel Medina
• Mary P Medwar, DC
• Zumra Mehmedovic, PMHNP
• David Melchiorri, DPT
• Melissa M Thompson DMD, PC

• Clinical Social Worker in Woburn, MA
• Providers in Woburn, 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 Oct 27, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.