Individual provider Active NPI

Irene Belozersky, LICSW

  • Clinical Social Worker
  • Brookline, MA
National Provider Identifier
1851448864
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1018820 Issued in MA
Practice address
124 Harvard St
Suite 2B
Brookline, MA 02446-6478
Phone
(617) 457-8582
Fax
(617) 988-6262
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 1018820 MA Primary

Addresses

Primary practice location

124 Harvard St
Suite 2B
Brookline, MA 02446-6478

Mailing address

500 Washington St
Brookline, MA 02446-4516
Phone (617) 457-8582

Other identifiers 5

IdentifierTypeStateIssuer
1853902MedicaidMA
1892401MedicaidMA
340924OtherMAMAGELLAN
BCBSMAOtherMABEPO5836
112919OtherMAUBH

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
I20040319000239 MA Practitioner - Clinical Social Worker 3971493743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

124 Harvard St
Suite 2B
Brookline, MA 02446-6439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1018820MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family & Children'S Service Past Accepting new patients

Organizations & group practices 2

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1851448864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WASHINGTON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464516",
            "telephone_number": "617-457-8582",
            "fax_number": "617-988-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 HARVARD ST",
            "address_2": "SUITE 2B",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024466478",
            "telephone_number": "617-457-8582",
            "fax_number": "617-988-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELOZERSKY",
        "first_name": "IRENE",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1018820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1853902",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1892401",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "340924",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEPO5836",
            "identifier": "BCBSMA",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "112919",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.