Maturin Frye Waldo, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007236 Issued in CT

Practice address

21 Montauk Ave
New London, CT 06320-4906

Phone

(860) 271-4700

Fax

(860) 271-4797

NPI assigned

Sep 23, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Fordham University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Connecticut Behavioral Health Assoc PCGroup PAC ID 4385532373, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maturin.waldo.1@32885.direct.athenahealth.com

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.

• Connecticut Behavioral Health Assoc, P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, CT
  • NPI 1629158126

  Clinical

  Medicare reassignment Care Compare group NPD
• Urologic Associates, PC

  • Urology Physician
  • New London, CT
  • NPI 1740362730
  NPD (past)
• Catholic Charities Neighborhood Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn, NY
  • NPI 1548373921
  NPD (past)

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1629178348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063200390",
            "telephone_number": "860-271-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204906",
            "telephone_number": "860-271-4700",
            "fax_number": "860-271-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDO",
        "first_name": "MATURIN",
        "middle_name": "FRYE",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-23",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Volke, MD
• Andrea Vuono, MS, CCC-SLP
• Gerald Wagner Jr., LADC
• Janice Waid, MFT
• Timothy G Waksmonski
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Ashleigh Monya Walker, HS3
• George McGwaine Walker, PHD, LPC, NCC

• Clinical Social Worker in New London, CT
• Providers in New London, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.