Individual provider Active NPI

Gregory Pamphile

  • Clinical Social Worker
  • Stoughton, MA
National Provider Identifier
1629426390
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000121469 Issued in MA
Practice address
532 Page St
Stoughton, MA 02072-6003
Phone
(774) 240-6827
Fax
(617) 829-9596
NPI assigned
Jun 2, 2016
Last updated
Feb 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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 000121469 MA Primary

Addresses

Primary practice location

532 Page St
Stoughton, MA 02072-6003

Mailing address

532 Page St
Stoughton, MA 02072-6003
Phone (774) 240-6827

Other practice location 1

110 Liberty St
Brockton, MA 02301-5674
Phone (508) 894-0548

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL gregpsocial@gmail.com Direct

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
I20190102000916 MA Practitioner - Clinical Social Worker 2961747464 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000121469MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Healthcare Medical Group Inc Social Worker CurrentSince Feb 1, 2024 Accepting new patients

Locations

110 Liberty St
Brockton, MA 02301

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

Interoperability endpoints

  • Direct secure messaging: gregory.pamphile@direct.signature.masshiway.net

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, 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": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1629426390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 PAGE ST",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020726003",
            "telephone_number": "774-240-6827",
            "fax_number": "617-829-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 PAGE ST",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020726003",
            "telephone_number": "774-240-6827",
            "fax_number": "617-829-9596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Liberty St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023015674",
            "country_code": "US",
            "telephone_number": "508-894-0548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAMPHILE",
        "first_name": "GREGORY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-02",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000121469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "gregpsocial@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Business Email",
            "address_1": "532 Page St",
            "city": "Stoughton",
            "state": "MA",
            "country_code": "US",
            "postal_code": "020726003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stoughton, MA

Sources for this page

Verify at the official NPI Registry.