MAKOTO TANAKA (LCSW) – Clinical Social Worker, NPI 1073706727

MAKOTO TANAKA (LCSW) is a healthcare provider. based in Somerville, Massachusetts. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 0904009432 (VA). The NPI Number for MAKOTO TANAKA (LCSW) is 1073706727

Main info

Male
18 Years Of Experience
Accepts Medicare Assignment
Name
MAKOTO TANAKA (LCSW)
NPI
1073706727
Phone
(571) 213-9512
Address
162 SUMMER ST
Enumeration Date
24 August 2007
Last Update Date
22 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7033217000
Graduation Year
2008 (18 years ago)
PAC ID
7719233527
Group Practice PAC ID
9739136847
Professional Enrollment ID
I20180710001594
Address ID
VA220314512FA8221XDRXX509
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:18State licenses:1Digital endpointsOther names

4,194 CLINICAL SOCIAL WORKER in MA

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Provider Addresses for MAKOTO TANAKA (LCSW)

  • 162, Summer Street, Spring Hill, Somerville, Middlesex County, Massachusetts, 02143, United States

    #15

    SOMERVILLE, MA 021432626

    Phone: (571) 213-9512

    Type: Mailing

  • Cambridge Hospital, 1493, Cambridge Street, Inman Square, Cambridge, Middlesex County, Massachusetts, 02139, United States

    CAMBRIDGE, MA 021391047

    Phone: (617) 665-1185

    Type: Location

  • 6901 S VAN DORN ST

    ALEXANDRIA, VA 223153961

    Phone: (703) 313-6323

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-07-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180710001594IClinical Social WorkerDCTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02143)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739136847View full group profile
NameSpecialtyState
Nurse PractitionerVA
P S Y C H I A T R YMD
P S Y C H I A T R YDC
P S Y C H I A T R YVA
Clinical PsychologistVA
Mental Health CounselorVA
Clinical Social WorkerVA
P S Y C H I A T R YVA
Clinical Social WorkerVA
Internal MedicineVA

Reviews

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Frequently asked questions

Is there an official ID for MAKOTO TANAKA (LCSW) in U.S. healthcare records?
The official identifier for MAKOTO TANAKA (LCSW) is NPI 1073706727.
Is MAKOTO TANAKA (LCSW) still an active registrant?
MAKOTO TANAKA (LCSW) carries an active NPI according to the public dataset.
What area of care is associated with MAKOTO TANAKA (LCSW)?
MAKOTO TANAKA (LCSW)'s record emphasizes Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What locale is associated with MAKOTO TANAKA (LCSW)?
Directory geography for MAKOTO TANAKA (LCSW) centers on Somerville, Massachusetts.
Does MAKOTO TANAKA (LCSW) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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