Individual provider Active NPI

Kim M. Hager, MSW

  • Clinical Social Worker
  • Worcester, MA
National Provider Identifier
1922327261
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117095 Issued in MA
Practice address
135 Gold Star Blvd
Worcester, MA 01606-2738
Phone
(508) 459-6400
Fax
(508) 849-5618
NPI assigned
May 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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 117095 MA Primary

Addresses

Primary practice location

135 Gold Star Blvd
Worcester, MA 01606-2738

Mailing address

135 Gold Star Blvd
Worcester, MA 01606-2738
Phone (508) 459-6400

Other names 1

  • Miss Kim Maleno Former name

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
I20140827002648 MA Practitioner - Clinical Social Worker 1355569617 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Youth Opportunities Upheld, Inc. CurrentSince Oct 12, 2021 Accepting new patients

Locations

135 Gold Star Blvd
Worcester, MA 01606
Phone (508) 459-6400

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/youinc/r4/

Organizations & group practices 1

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": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1922327261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 GOLD STAR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062738",
            "telephone_number": "508-459-6400",
            "fax_number": "508-849-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 GOLD STAR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062738",
            "telephone_number": "508-459-6400",
            "fax_number": "508-849-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGER",
        "first_name": "KIM",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-26",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "MALENO",
            "prefix": "MISS",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.