Individual provider Active NPI

Michelle L Rubin-Digirolamo, LICSW

  • Clinical Social Worker
  • Medford, MA
National Provider Identifier
1528209343
Registry record updated Apr 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111406 Issued in MA
Practice address
170 Governors Ave
Behavioral Health Services
Medford, MA 02155-1643
Phone
(781) 306-6008
Fax
(781) 306-6146
NPI assigned
Mar 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2013

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 111406 MA Primary

Addresses

Primary practice location

170 Governors Ave
Behavioral Health Services
Medford, MA 02155-1643

Mailing address

170 Governors Ave
Behavioral Health Services
Medford, MA 02155-1643
Phone (781) 306-6008

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
I20090407000506 MA Practitioner - Clinical Social Worker 3870640907 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hallmark Health Medical Associates IncGroup PAC ID 4385638782, 151 clinicians

Practice addresses (Care Compare)

178 Savin St
Suite 200
Malden, MA 02148-3591
Phone (781) 338-7250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111406MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health Medical Associates Inc CurrentSince Feb 23, 2019 Accepting new patients
Melrosewakefield Healthcare, Inc. Current Accepting new patients

Locations

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

Organizations & group practices 2

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": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365379200000",
    "number": "1528209343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 GOVERNORS AVE",
            "address_2": "BEHAVIORAL HEALTH SERVICES",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551643",
            "telephone_number": "781-306-6008",
            "fax_number": "781-306-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 GOVERNORS AVE",
            "address_2": "BEHAVIORAL HEALTH SERVICES",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551643",
            "telephone_number": "781-306-6008",
            "fax_number": "781-306-6146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN-DIGIROLAMO",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2013-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.