Individual provider Active NPI

Trista Escobar Metz, LICSW

  • Clinical Social Worker
  • Falmouth, MA
National Provider Identifier
1992988695
Registry record updated Feb 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
200 Ter Heun Dr
Falmouth, MA 02540-2525
Phone
(508) 540-6550
Fax
(508) 540-7480
NPI assigned
Dec 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2019

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 Primary

Addresses

Primary practice location

200 Ter Heun Dr
Falmouth, MA 02540-2525

Mailing address

26 Smith St
Seekonk, MA 02771-6013
Phone (401) 699-2845

Other names 1

  • Trista Escobar Metz Former name

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
I20170412001703 MA Practitioner - Clinical Social Worker 9436433265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Fairwinds-Nantuckets Counseling CenterGroup PAC ID 7517997992, 6 clinicians

Practice addresses (Care Compare)

20 Vesper LN
Unit L1
Nantucket, MA 02554-4394
Phone (508) 228-2689

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fairwinds-Nantuckets Counseling Center CurrentSince Apr 10, 2022 Accepting new patients
Fairwinds-Nantucket'S Counseling Center, Inc PastSince Apr 10, 2022 Accepting new patients

Locations

20 Vesper Ln
Unit L1
Nantucket, MA 02554
Phone (508) 228-2689

Organizations & group practices 2

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": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549670400000",
    "number": "1992988695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SMITH ST",
            "city": "SEEKONK",
            "state": "MA",
            "postal_code": "027716013",
            "telephone_number": "401-699-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TER HEUN DR",
            "city": "FALMOUTH",
            "state": "MA",
            "postal_code": "025402525",
            "telephone_number": "508-540-6550",
            "fax_number": "508-540-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZ",
        "first_name": "TRISTA",
        "middle_name": "ESCOBAR",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-17",
        "last_updated": "2019-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRISTA",
            "last_name": "METZ",
            "middle_name": "ESCOBAR",
            "credential": "ISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Falmouth, MA

Sources for this page

Verify at the official NPI Registry.