Active NPI
Dennis Balcom, MSW
- Clinical Social Worker
- Cambridge, MA
National Provider Identifier
1891785812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 100275
- Practice address
- 263 Concord Ave # 1
Cambridge, MA 02138-1336 - Phone
- (617) 661-1358
- Fax
- (617) 661-1359
- NPI assigned
- Oct 21, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 100275 | MA | Primary |
Addresses
Primary practice location
263 Concord Ave # 1
Cambridge, MA 02138-1336
Mailing address
263 Concord Ave # 1
Cambridge, MA 02138-1336
Phone (617) 661-1358
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2017 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273795200000",
"number": "1891785812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 CONCORD AVE # 1",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021381336",
"telephone_number": "617-661-1358",
"fax_number": "617-661-1359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 CONCORD AVE # 1",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021381336",
"telephone_number": "617-661-1358",
"fax_number": "617-661-1359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALCOM",
"first_name": "DENNIS",
"name_prefix": "Mr.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-21",
"last_updated": "2010-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "100275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.