Individual provider Active NPI

Nathan Keedy, LICSW

  • Clinical Social Worker
  • Worcester, MA
National Provider Identifier
1841245693
Registry record updated Nov 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
101228 Issued in MA
Practice address
100 Century Dr
Worcester, MA 01606
Phone
(508) 762-5400
Fax
(508) 762-5410
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 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 101228 MA Primary

Addresses

Primary practice location

100 Century Dr
Worcester, MA 01606

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nkeedy22994@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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
I20050922000228 MA Practitioner - Clinical Social Worker 9537193230 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Jonathan Rothman MDGroup PAC ID 7719936905, 5 clinicians
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

154 E Main St
Westborough, MA 01581-1768
Phone (508) 791-5540

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
101228MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group, Inc. CurrentSince Jan 10, 2019 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Jan 10, 2019 Accepting new patients
Jonathan Rothman MD Clinical CurrentSince Sep 16, 2012 Accepting new patients
Jonathan Rothman, M.D. Clinical Past Accepting new patients

Locations

154 E Main St
Westborough, MA 01581
Phone (508) 366-7899

154 E Main St
Ste 201
Westborough, MA 01581

100 Century Dr
Worcester, MA 01606
Phone (508) 762-5400

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: nkeedy22994@umassmemorial.direct-ci.com

Organizations & group practices 5

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606608000000",
    "number": "1841245693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CENTURY DR",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01606",
            "telephone_number": "508-762-5400",
            "fax_number": "508-762-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEDY",
        "first_name": "NATHAN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-11-29",
        "certification_date": "2020-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "101228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkeedy22994@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "100 Century Dr",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "01606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "100 Century Dr",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "01606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.