Active NPI
Samuel P Chiancola, LICSW
- Social Worker
- Milford, MA
National Provider Identifier
1871617035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 01355
- Practice address
- 260 Main St
Milford, MA 01757 - Phone
- (508) 473-4674
- Fax
- (508) 865-6059
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 01355 | MA | Primary |
Addresses
Primary practice location
260 Main St
Milford, MA 01757
Mailing address
20 Old Mill Rd
Sutton, MA 01590
Phone (508) 865-6059
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121127000000 | MA | Practitioner - Clinical Social Worker | 2264683184 | Practice locations: Sutton, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1970
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
20 Old Mill Rd
Sutton, MA 01590-1128
Phone (508) 865-6059
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01355 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349913600000",
"number": "1871617035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 OLD MILL RD",
"city": "SUTTON",
"state": "MA",
"postal_code": "01590",
"telephone_number": "508-865-6059",
"fax_number": "508-865-6059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 MAIN ST",
"city": "MILFORD",
"state": "MA",
"postal_code": "01757",
"telephone_number": "508-473-4674",
"fax_number": "508-865-6059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIANCOLA",
"first_name": "SAMUEL",
"middle_name": "P",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2012-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "01355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.