Individual provider Active NPI

Nikolas Zanetti

  • Clinical Social Worker
  • Waltham, MA
National Provider Identifier
1972209096
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
124735 Issued in MA
Practice address
94 Cushing St Unit 2
Waltham, MA 02453-0477
Phone
(617) 600-8705
NPI assigned
Jan 31, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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 124735 MA Primary

Addresses

Primary practice location

94 Cushing St Unit 2
Waltham, MA 02453-0477

Mailing address

94 Cushing St Unit 2
Waltham, MA 02453-0477
Phone (617) 600-8705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
124735MAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1972209096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 CUSHING ST UNIT 2",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024530477",
            "telephone_number": "617-600-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 CUSHING ST UNIT 2",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024530477",
            "telephone_number": "617-600-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANETTI",
        "first_name": "NIKOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "124735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.