Ann Bergan Fitzgerald, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

110624 Issued in MA

Practice address

10 Cabot Rd FL 1
Medford, MA 02155-5177

Phone

(781) 393-5152

Fax

(781) 393-5168

NPI assigned

Dec 18, 2006

Last updated

Nov 20, 2015By the provider in NPPES

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 9

Other names 1

• Ms. Ann Gretchen Bergan Former name

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, 1997

Medicare assignment

May accept Medicare assignment

Group practices

North End Community Health Committee, Inc.Group PAC ID 8224043971, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• North End Community Health Committee Inc

  dba North End Community Health Center

  • Public Health & General Preventive Medicine Physician
  • Boston, MA
  • NPI 1780606608
  Medicare reassignment Care Compare group NPD
• Eliot Community Human Services

  dba Eliot Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lexington, MA
  • NPI 1679648182
  Medicare reassignment NPD
• The Counseling Center of Child Development, in

  • Clinical Social Worker
  • Medford, MA
  • NPI 1518164508
  NPD (past) Authorized official
• Eliot Community Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lexington, MA
  • NPI 1932271632
  NPD

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1538222716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 CHELSEA ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "02149",
            "telephone_number": "781-861-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CABOT RD FL 1",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555177",
            "telephone_number": "781-393-5152",
            "fax_number": "781-393-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "ANN",
        "middle_name": "BERGAN",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI-PLAN",
            "identifier": "12515715",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1518164508",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBHP",
            "identifier": "1518164508",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "1538222716",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "486325",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9186232",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH PLAN",
            "identifier": "1518164508",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "1518164508",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "987309-02",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "BERGAN",
            "middle_name": "GRETCHEN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Finkle
• Mary E. Finn, OTR
• Sara A Firment
• First Dental, PC
• Maureen Minahan Fisher, PTA, LMT
• Patricia Anne Flanagan, RN
• Judy Fleishman
• Addie Clare Fletcher, RNCS
• Evan Fletcher
• Mark Florentino

• Clinical Social Worker in Medford, MA
• Providers in Medford, 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 Nov 20, 2015; 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.