Individual provider Active NPI

Robert Jon Boyle

  • Clinical Social Worker
  • Woodland Hills, CA
National Provider Identifier
1558470757
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS11825 Issued in CA
Practice address
4869 Topanga Canyon Blvd
Suite 6
Woodland Hills, CA 91364-4255
Phone
(818) 346-5186
Fax
(818) 883-9752
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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 LCS11825 CA Primary

Addresses

Primary practice location

4869 Topanga Canyon Blvd
Suite 6
Woodland Hills, CA 91364-4255

Mailing address

20751 Dumont St
Woodland Hills, CA 91364-3402
Phone (818) 346-5186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100622000398 CA Practitioner - Clinical Social Worker 2365573227 Practice locations: Woodland Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4869 Topanga Canyon Blvd
Suite 6
Woodland Hills, CA 91364-4255
Phone (818) 346-5186

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS11825CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558470757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20751 DUMONT ST",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913643402",
            "telephone_number": "818-346-5186",
            "fax_number": "818-883-9752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4869 TOPANGA CANYON BLVD",
            "address_2": "SUITE 6",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913644255",
            "telephone_number": "818-346-5186",
            "fax_number": "818-883-9752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "ROBERT",
        "middle_name": "JON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS11825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

Verify at the official NPI Registry.