Individual provider Active NPI

Howard Mark Buckwold

  • Clinical Social Worker
  • Pittsburgh, PA
National Provider Identifier
1912610213
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW025071 Issued in PA
Practice address
5830 Ellsworth Ave Ste 301
Pittsburgh, PA 15232-1778
Phone
(855) 284-7483
Fax
(617) 807-0958
NPI assigned
Jan 2, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW138590 PA
Clinical Social Worker 1041C0700X CW025071 PA Primary

Addresses

Primary practice location

5830 Ellsworth Ave Ste 301
Pittsburgh, PA 15232-1778

Mailing address

PO Box 748465
Atlanta, GA 30374-8465
Phone (855) 284-7483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20241009000379 PA Practitioner - Clinical Social Worker 5698206001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Directions Mental Health, PCGroup PAC ID 0345228318, 153 clinicians

Practice addresses (Care Compare)

1000 Gamma Dr
Suite 501
Pittsburgh, PA 15238-2926
Phone (724) 374-3468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW138590PAMDSocial Worker
CW025071PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Sep 25, 2024 Accepting new patients
New Directions Mental Health, PC Clinical CurrentSince Dec 3, 2024 Accepting new patients
Intercare Health Systems, LTD, Dba Intercare Psychiatric Services PastSince Dec 3, 2024 Accepting new patients

Locations

110 Hidden Valley Rd
McMurray, PA 15317
Phone (724) 941-4040

5830 Ellsworth Ave
Ste 301
Pittsburgh, PA 15232
Phone (412) 208-6279

1000 Gamma Dr
Ste 501
Pittsburgh, PA 15238
Phone (412) 249-9288

Organizations & group practices 3

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": "1672617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1912610213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748465",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748465",
            "telephone_number": "855-284-7483",
            "fax_number": "617-807-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 ELLSWORTH AVE STE 301",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152321778",
            "telephone_number": "855-284-7483",
            "fax_number": "617-807-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKWOLD",
        "first_name": "HOWARD",
        "middle_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-02",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW138590",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW025071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.