Janice K. Wagner, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

105968 Issued in MA

Practice address

147 Milk St
Boston, MA 02109-4806

Phone

(617) 654-7300

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Atrius Health, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1841413887
  NPD (past)
• Sustain Physical Therapy and Performance

  • Physical Therapy Clinic/Center
  • Boston, MA
  • NPI 1144745902
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239148800000",
    "number": "1497779466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 MILK ST",
            "address_2": "PROVIDER ENROLLMENT 9TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021094806",
            "telephone_number": "617-559-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 MILK ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021094806",
            "telephone_number": "617-654-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JANICE",
        "middle_name": "K.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2009-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "105968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0014259",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "669489",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "P06820",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew A Wagner, M.D.
• Andrew J Wagner, M.D.
• Benjamin Alexander Wagner, MD
• Cynthia Wise Wagner, M.S., CCC-SLP
• Ethan Scott Wagner, MD
• Jill Wagner, LICSW
• Lindsay Wagner, PSY.D.
• Maureen Wagner, RN
• Michael J Wagner
• Rachel Ann Wagner, AUD

• Clinical Social Worker in Boston, MA
• Providers in Boston, 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 Apr 8, 2009; 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.