Individual provider Active NPI

Robin Bromberg, LICSW

  • Clinical Social Worker
  • Brighton, MA
National Provider Identifier
1528548609
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1025402 Issued in MA
Practice address
30 Wallingford Rd
Brighton, MA 02135-4708
Phone
(617) 912-8487
NPI assigned
Aug 17, 2018
Last updated
Aug 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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 1025402 MA Primary

Addresses

Primary practice location

30 Wallingford Rd
Brighton, MA 02135-4708

Mailing address

68 Preston St Apt 7a
Wakefield, MA 01880-2564
Phone (781) 718-4815

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
I20040312000024 MA Practitioner - Clinical Social Worker 5193614790 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

77 Herrick St
Suite 101
Beverly, MA 01915-2734
Phone (978) 927-4110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Starting Line Wellness, LLC CurrentSince Dec 29, 2020 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Jun 1, 2020 Accepting new patients
Atrius Health, Inc. CurrentSince Dec 16, 2024 Accepting new patients
Atrius Health, Inc. Clinical Current Accepting new patients
Atrius Health, Inc. CurrentSince Dec 16, 2024 Accepting new patients

Locations

77 Herrick St
Ste 101
Beverly, MA 01915
Phone (978) 232-7115

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

75 Francis St
Boston, MA 02115

850 Boylston St
Chestnut Hill, MA 02467
Phone (617) 732-5773

Interoperability endpoints

  • Direct secure messaging: rbromberglicsw392161@direct.atrius.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1528548609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 PRESTON ST APT 7A",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018802564",
            "telephone_number": "781-718-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WALLINGFORD RD",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021354708",
            "telephone_number": "617-912-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMBERG",
        "first_name": "ROBIN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1025402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.