Individual provider Active NPI

Alyssa Meltzer, LCSW

  • Clinical Social Worker
  • Salem, OR
National Provider Identifier
1639731649
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L12340 Issued in OR
Practice address
2478 13TH St SE
Salem, OR 97302-2522
Phone
(503) 362-2481
Fax
(503) 371-7803
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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 L12340 OR Primary

Addresses

Primary practice location

2478 13TH St SE
Salem, OR 97302-2522

Mailing address

2478 13TH St SE
Salem, OR 97302-2522
Phone (503) 362-2481

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231107003558 OR Practitioner - Clinical Social Worker 1951632330 Reassigns benefits to 1 organization
I20231108001783 WA Practitioner - Clinical Social Worker 1951632330 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Sep 25, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Social Worker CurrentSince Sep 25, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Social Worker CurrentSince Sep 25, 2023 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

5125 Skyline Rd S
Salem, OR 97306
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1639731649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2478 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022522",
            "telephone_number": "503-362-2481",
            "fax_number": "503-371-7803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2478 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022522",
            "telephone_number": "503-362-2481",
            "fax_number": "503-371-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELTZER",
        "first_name": "ALYSSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L12340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.