Samantha Vaccaro, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

127294 Issued in MA

Practice address

21 Kreutzer Rd
Peru, MA 01235-9265

Phone

(413) 358-1099

NPI assigned

Apr 10, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ria Health PCGroup PAC ID 6204235682, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ria Health PC

  • Addiction Medicine (Internal Medicine) Physician
  • San Francisco, CA
  • NPI 1326539404

  MA

  Medicare reassignment Care Compare group NPD
• Embodied Counseling and Wellness LLC

  • Clinical Social Worker
  • Pittsfield, MA
  • NPI 1508750183
  NPD Authorized official

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1972999514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 KREUTZER RD",
            "city": "PERU",
            "state": "MA",
            "postal_code": "012359265",
            "telephone_number": "413-358-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 KREUTZER RD",
            "city": "PERU",
            "state": "MA",
            "postal_code": "012359265",
            "telephone_number": "413-358-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "359 Fenn St",
            "address_purpose": "LOCATION",
            "city": "Pittsfield",
            "state": "MA",
            "postal_code": "012015261",
            "country_code": "US",
            "telephone_number": "413-629-1262",
            "fax_number": "413-448-2198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VACCARO",
        "first_name": "SAMANTHA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "127294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Unknown",
            "affiliation": "N",
            "address_1": "21 Kreutzer Rd",
            "city": "Peru",
            "state": "MA",
            "country_code": "US",
            "postal_code": "012359265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.