Individual provider Active NPI

Michael Miarecki, LCSW

  • Clinical Social Worker
  • Hamden, CT
National Provider Identifier
1821426149
Registry record updated Oct 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
008271 Issued in CT
Practice address
1400 Whitney Ave
Hamden, CT 06517-2459
Phone
(203) 248-2116
Fax
(203) 287-9815
NPI assigned
Oct 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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 008271 CT Primary

Addresses

Primary practice location

1400 Whitney Ave
Hamden, CT 06517-2459

Mailing address

69-417 Westwood Knoll
Meriden, CT 06450
Phone (860) 748-2535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20161208000135 CT Practitioner - Clinical Social Worker 3870873813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middlesex HospitalGroup PAC ID 5092611731, shared by 7 NPIs, 231 clinicians

Practice addresses (Care Compare)

28 Crescent St
Middletown, CT 06457-3654

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008271CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince May 1, 2019 Accepting new patients
Middlesex Hospital Clinical CurrentSince May 1, 2019 Accepting new patients
Middlesex Hospital CurrentSince May 1, 2019 Accepting new patients
Connecticut Pathology Group PC Current Accepting new patients
The Children'S Center of Hamden, Inc. Past Accepting new patients
The Children'S Center of Hamden, Inc. Past Accepting new patients

Locations

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

90 S Main St
Middletown, CT 06457
Phone (860) 358-6300

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382486400000",
    "number": "1821426149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69-417 WESTWOOD KNOLL",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "06450",
            "telephone_number": "860-748-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WHITNEY AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065172459",
            "telephone_number": "203-248-2116",
            "fax_number": "203-287-9815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIARECKI",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-23",
        "last_updated": "2013-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.