Individual provider Active NPI

Isidra Guadalupe Hernandez-Morelos, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1982913315
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
120095 Issued in MA
Practice address
1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone
(617) 414-5245
Fax
(617) 414-5520
NPI assigned
Oct 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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 120095 MA Primary

Addresses

Primary practice location

1 Boston Medical Ctr PL
Boston, MA 02118-2908

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118-2690

Other identifiers 1

IdentifierTypeStateIssuer
110120872AMedicaidMA

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
I20170220000777 MA Practitioner - Clinical Social Worker 6507149432 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boston University Psychiatry Associates, Inc.Group PAC ID 7911805361, 104 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 414-5245

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
120095MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medical Associates-Ebnhc CurrentSince Feb 23, 2017 Accepting new patients
Neighborhealth Corporation CurrentSince Feb 23, 2017 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Boston University Psychiatry Associates, Inc. CurrentSince Sep 24, 2018 Accepting new patients

Locations

85 East Newton St
Ste 905
Boston, MA 02118
Phone (617) 414-5245

960 Massachusetts Ave
Ste 2
Boston, MA 02118

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: ihernandezmorelos113402@direct.bmc.masshiway.net

Organizations & group practices 4

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1982913315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CTR PL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182908",
            "telephone_number": "617-414-5245",
            "fax_number": "617-414-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ-MORELOS",
        "first_name": "ISIDRA GUADALUPE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "120095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110120872A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.