Ivy Medeiros, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW02077 Issued in RI

Practice address

245 Main St
Woonsocket, RI 02895-3123

Phone

(401) 235-7000

Fax

(401) 767-4516

NPI assigned

Jul 6, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Infinite Revival, PC

  • Health Service Clinic/Center
  • Seekonk, MA
  • NPI 1467282061

  MA

  Medicare reassignment NPD

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1831610344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1700",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028950856",
            "telephone_number": "401-235-7000",
            "fax_number": "401-767-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MAIN ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953123",
            "telephone_number": "401-235-7000",
            "fax_number": "401-767-4516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1087 Newman Ave",
            "address_purpose": "LOCATION",
            "city": "Seekonk",
            "state": "MA",
            "postal_code": "027714426",
            "country_code": "US",
            "telephone_number": "508-557-1432",
            "fax_number": "508-318-1117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDEIROS",
        "first_name": "IVY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyce Ann McIntosh, PA-C
• Megan Crawford McKain, CNM
• Allan B McKinnon, LCDP
• Shaylyn Kathleen McTeague, D.P.M
• Med-Y-Care LLC
• Medical Group of New York Acute Care PLLC
• Medical Imaging Assoc Inc
• Medical Imaging Associates Inc
• Michael Medouris, PHARMD
• Syed R Mehdi, MD

• All providers in Woonsocket, RI
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.