Individual provider Active NPI

Jacqueline M Shock-Stewart, LCSW

  • Clinical Social Worker
  • Wexford, PA
National Provider Identifier
1801234604
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW017735 Issued in PA
Practice address
12311 Perry Hwy
Wexford, PA 15090-8344
Phone
(878) 332-4240
Fax
(878) 332-4481
NPI assigned
Jun 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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 CW017735 PA Primary

Addresses

Primary practice location

12311 Perry Hwy
Wexford, PA 15090-8344

Mailing address

12311 Perry Hwy
Wexford, PA 15090-8344
Phone (878) 332-4240

Other identifiers 1

IdentifierTypeStateIssuer
103077862MedicaidPA

Other names 1

  • Jacqueline M Shock Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jshockstewart100054@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20140325001337 PA Practitioner - Clinical Social Worker 6608007232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allegheny ClinicGroup PAC ID 5395649586, 2,313 clinicians

Practice addresses (Care Compare)

1301 Carlisle St
Natrona Heights, PA 15065-1152
Phone (724) 226-7380

1307 Federal St
Pittsburgh, PA 15212-4769

4 Allegheny Ctr
FL 8
Pittsburgh, PA 15212-5255
Phone (412) 330-4000

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic CurrentSince Jul 25, 2016 Accepting new patients
Allegheny Clinic Clinical CurrentSince Jul 25, 2016 Accepting new patients
Allegheny Clinic Current Accepting new patients
Allegheny Clinic Clinical Past Accepting new patients

Locations

2315 Myrtle St
Ste 260
Erie, PA 16502
Phone (814) 452-6558

4 Allegheny Ctr
Fl 8
Pittsburgh, PA 15212
Phone (412) 330-4242

12311 Perry Hwy
Wexford, PA 15090
Phone (878) 332-4143

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1801234604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12311 PERRY HWY",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908344",
            "telephone_number": "878-332-4240",
            "fax_number": "878-332-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12311 PERRY HWY",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908344",
            "telephone_number": "878-332-4240",
            "fax_number": "878-332-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCK-STEWART",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-13",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103077862",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshockstewart100054@direct.ahn.org",
            "affiliation": "N",
            "address_1": "12311 Perry Hwy",
            "city": "Wexford",
            "state": "PA",
            "country_code": "US",
            "postal_code": "150908344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "SHOCK",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wexford, PA

Sources for this page

Verify at the official NPI Registry.