Individual provider Active NPI

Michael Patrick Monaco

  • Clinical Social Worker
  • Cambridge, MA
National Provider Identifier
1629041330
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
107745 Issued in MA
Practice address
75 Mount Auburn St
Cambridge, MA 02138-4960
Phone
(617) 495-2323
Fax
(617) 495-2327
NPI assigned
Feb 12, 2006
Last updated
Mar 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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 107745 MA Primary

Addresses

Primary practice location

75 Mount Auburn St
Cambridge, MA 02138-4960

Mailing address

75 Mount Auburn St
Cambridge, MA 02138-4960
Phone (617) 495-2323

Other identifiers 1

IdentifierTypeStateIssuer
P10297OtherMABLUE CROSS/BLUE SHIELD

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
I20050917000173 MA Practitioner - Clinical Social Worker 7012940299 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

75 Mount Auburn St
Cambridge, MA 02138-4960
Phone (617) 496-8700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107745MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brookline Community Mental Health Center Inc. CurrentSince Jun 18, 2001 Accepting new patients
President & Fellows of Harvard College CurrentSince Feb 18, 2015 Accepting new patients
President and Fellows of Harvard College CurrentSince Feb 18, 2015 Accepting new patients

Locations

188 Longwood Ave
Boston, MA 02115
Phone (617) 432-1434

43 Garrison Rd
Brookline, MA 02445
Phone (617) 277-8107

75 Mount Auburn St
Cambridge, MA 02138
Phone (617) 495-2042

75 Mount Auburn St
#H
Cambridge, MA 02138
Phone (617) 495-4414

Organizations & group practices 3

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": "1139702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1629041330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-2323",
            "fax_number": "617-495-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-2323",
            "fax_number": "617-495-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONACO",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-12",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "107745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "P10297",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.