Individual provider Active NPI

Maryann Tuttobene, LICSW

  • Clinical Social Worker
  • Manchester, NH
National Provider Identifier
1952801318
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2083 Issued in NH
Practice address
138 Webster St
Manchester, NH 03104-2512
Phone
(603) 645-5977
Fax
(603) 645-5980
NPI assigned
Feb 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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 2083 NH Primary

Addresses

Primary practice location

138 Webster St
Manchester, NH 03104-2512

Mailing address

PO Box 3300
Manchester, NH 03105-3300
Phone (603) 645-5977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20180219000215 NH Practitioner - Clinical Social Worker 8022379825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jwalant Vadalia MD PCGroup PAC ID 5698666337, 16 clinicians

Practice addresses (Care Compare)

138 Webster St
Manchester, NH 03104-2512
Phone (603) 645-5977

Merit-based Incentive Payment System (MIPS)

Final score
50.01 of 100Reported as group
Quality
7.83
Improvement activities
40
Cost
80.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2083NHMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Jwalant Vadalia MD PC CurrentSince Jan 8, 2018 Accepting new patients

Locations

138 Webster St
Manchester, NH 03104
Phone (603) 645-5977

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": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1952801318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3300",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031053300",
            "telephone_number": "603-645-5977",
            "fax_number": "603-645-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 WEBSTER ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042512",
            "telephone_number": "603-645-5977",
            "fax_number": "603-645-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTOBENE",
        "first_name": "MARYANN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "2083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.