Individual provider Active NPI

Brandee Henderson

  • Social Worker
  • Waltham, MA
National Provider Identifier
1649656570
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1430 Main St
Waltham, MA 02451-1623
Phone
(781) 647-5327
NPI assigned
Aug 3, 2015
Last updated
Aug 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

1430 Main St
Waltham, MA 02451-1623

Mailing address

1430 Main St
Waltham, MA 02451-1623

Other identifiers 1

IdentifierTypeStateIssuer
042104356MedicaidMA

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
I20210824003516 MA Practitioner - Clinical Social Worker 3476958737 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

4 Brotherton Way
Auburn, MA 01501-2684
Phone (508) 832-9621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Community Physicians Inc CurrentSince Jul 9, 2021 Accepting new patients
Mass General Brigham Community Physicians Inc. CurrentSince Jul 9, 2021 Accepting new patients
Reliant Medical Group, Inc CurrentSince Aug 26, 2024 Accepting new patients
Mass General Brigham Community Physicians Inc. Current Accepting new patients

Locations

4 Brotherton Way
Auburn, MA 01501
Phone (508) 425-5446

500 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

11 Mount Auburn St
Watertown, MA 02472
Phone (781) 653-0100

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
Fl 12
Worcester, MA 01606
Phone (508) 852-6175

Organizations & group practices 4

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": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1649656570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 MAIN ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 MAIN ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511623",
            "telephone_number": "781-647-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "BRANDEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042104356",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.