Individual provider Active NPI

Robert G. Childers, LCSW

  • Clinical Social Worker
  • San Francisco, CA
National Provider Identifier
1992828412
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS14719 Issued in CA
Practice address
298 Monterey Blvd
San Francisco, CA 94131-3140
Phone
(415) 337-4795
Fax
(415) 337-4816
NPI assigned
Apr 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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 LCS14719 CA Primary

Addresses

Primary practice location

298 Monterey Blvd
San Francisco, CA 94131-3140

Mailing address

298 Monterey Blvd
San Francisco, CA 94131-3140
Phone (415) 337-4795

Other identifiers 2

IdentifierTypeStateIssuer
1130OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER
1130OtherSFGH INTERNAL USE ONLY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • 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
I20091208000667 MA Practitioner - Clinical Social Worker 4880632892 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS14719CAMDClinical Social Worker
14719CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael W. Marcus, M.D., P.C. Clinical CurrentSince Oct 22, 2019 Accepting new patients

Locations

898 Main St
Winchester, MA 01890
Phone (781) 721-2737

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1992828412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 MONTEREY BLVD",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941313140",
            "telephone_number": "415-337-4795",
            "fax_number": "415-337-4816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 MONTEREY BLVD",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941313140",
            "telephone_number": "415-337-4795",
            "fax_number": "415-337-4816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "ROBERT",
        "middle_name": "G.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS14719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER",
            "identifier": "1130",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SFGH INTERNAL USE ONLY",
            "identifier": "1130",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.