Kimberly A Waggoner, MSW - Medicare Clinical Social Worker in East Providence, RI

Kimberly A Waggoner, MSW is a medicare enrolled "Social Worker - Clinical" provider in East Providence, Rhode Island. Her current practice location is 400 Massasoit Ave Ste 101, East Providence, Rhode Island. You can reach out to her office (for appointments etc.) via phone at (401) 612-7693.

Kimberly A Waggoner is licensed to practice in Rhode Island (license number ISW00879) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114954302.

Contact Information

Kimberly A Waggoner, MSW
400 Massasoit Ave Ste 101,
East Providence, RI 02914-2017
(401) 612-7693
(401) 432-1500



Healthcare Provider's Profile

Full NameKimberly A Waggoner
GenderFemale
SpecialitySocial Worker - Clinical
Location400 Massasoit Ave Ste 101, East Providence, Rhode Island
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1114954302
  • Provider Enumeration Date: 06/26/2006
  • Last Update Date: 08/28/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 4789813932
  • Enrollment ID: I20140210001197

Medical Identifiers

Medical identifiers for Kimberly A Waggoner such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114954302NPI-NPPES
KW10798MedicaidRI
62-23076OtherRIUNITED BEHAVIORAL HEALTH
413014OtherRIBLUE CHIP
31025-9OtherRIBLUE CROSS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical ISW00879 (Rhode Island)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly A Waggoner is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kimberly A Waggoner, MSW
400 Massasoit Ave Ste 101,
East Providence, RI 02914-2017

Ph: (401) 612-7693
Kimberly A Waggoner, MSW
400 Massasoit Ave Ste 101,
East Providence, RI 02914-2017

Ph: (401) 612-7693

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› Verified 9 days ago


Social Worker in East Providence, RI

Maria S Regan, MSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 1011 Veterans Memorial Pkwy, East Providence, RI 02915
Phone: 401-432-1160    Fax: 401-432-1500
Ms. Deborah Ann Furtado, M.S.W.,A.C.S.W.
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 146 Dover Ave, East Providence, RI 02914
Phone: 401-743-2433    
Julie K Klang, MSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 1011 Veterans Memorial Pkwy, East Providence, RI 02915
Phone: 401-432-1352    Fax: 401-432-1500
Coyna Peralta Pena, LCSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 975 Waterman Ave, East Providence, RI 02914
Phone: 401-235-7000    Fax: 401-767-4516
Ms. Diane Elizabeth Passantino, LICSW
Clinical Social Worker
Medicare: Accepting Medicare Assignments
Practice Location: 55 Dover Ave, East Providence, RI 02914
Phone: 401-248-5823    Fax: 401-406-2701
Mrs. Kerri-ann Soares Varela, LICSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 52 Humphrey St, East Providence, RI 02914
Phone: 401-617-9366    
Rebecca Kathleen Sousa, LICSW
Clinical Social Worker
Medicare: Accepting Medicare Assignments
Practice Location: 870 Waterman Ave, East Providence, RI 02914
Phone: 401-475-9979    

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