Individual provider Active NPI

Megan Marie Wall

  • Social Worker
  • New York, NY
National Provider Identifier
1699580324
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
115469 Issued in NY
Practice address
926 Broadway
New York, NY 10010
Phone
(833) 775-6252
NPI assigned
Feb 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22781 AZ
Social Worker 104100000X 115469 NY Primary

Addresses

Primary practice location

926 Broadway
New York, NY 10010

Mailing address

7659 E Golden River LN
Tucson, AZ 85715-3559
Phone (425) 530-7717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20251121004305 AZ Practitioner - Clinical Social Worker 9638661143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Park Health CenterGroup PAC ID 8325949647, 117 clinicians

Practice addresses (Care Compare)

1300 N 48TH St
Phoenix, AZ 85008-5803
Phone (602) 243-7277

3830 E Van Buren St
Phoenix, AZ 85008-6920
Phone (602) 243-7277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
115469NYMDSocial Worker
22781AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Park Health Center Current Accepting new patients
Mountain Park Health Center CurrentSince Nov 3, 2025 Accepting new patients
Mountain Park Health Center CurrentSince Nov 3, 2025 Accepting new patients

Locations

635 E Baseline Rd
Phoenix, AZ 85042

3830 E Van Buren St
Phoenix, AZ 85008
Phone (602) 806-6655

3003 N Central Ave
Ste 1600
Phoenix, AZ 85012
Phone (602) 323-3492

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": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1699580324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7659 E GOLDEN RIVER LN",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153559",
            "telephone_number": "425-530-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10010",
            "telephone_number": "833-775-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "MEGAN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "22781",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "115469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.