Individual provider Active NPI

Judith A Shute, LICSW

  • Clinical Social Worker
  • Worcester, MA
National Provider Identifier
1548356876
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1028056 Issued in MA
Practice address
255 Park Ave
Worcester, MA 01609-1953
Phone
(508) 799-0688
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1028056 MA Primary

Addresses

Primary practice location

255 Park Ave
Worcester, MA 01609-1953

Mailing address

35 Midgley LN
Worcester, MA 01604-3564
Phone (508) 756-8282

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
I20040127000219 MA Practitioner - Clinical Social Worker 8022910256 Reassigns benefits to 1 organization
Practice locations: Worcester, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

324 Grove St
Worcester, MA 01605-3936
Phone (508) 414-2459

35 Midgley LN
Worcester, MA 01604-3564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548356876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MIDGLEY LN",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016043564",
            "telephone_number": "508-756-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 PARK AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091953",
            "telephone_number": "508-799-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTE",
        "first_name": "JUDITH",
        "middle_name": "A",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1028056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.