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CAROLYN MARYAM MOODY LCSW
NPI 1093115867
Social Worker - Clinical in South San Francisco, CA

Active since August 29, 2014PECOS Enrolled
36 CHESTNUT AVE, #5553, SOUTH SAN FRANCISCO, CA 94083(415) 200-4587 Get Directions Write a Review

NPPES record last updated: July 21, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Carolyn Maryam Moody Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAROLYN MARYAM MOODY LCSW (NPI 1093115867) is an individual clinical provider in South San Francisco, California and active in the NPI registry since August 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093115867
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameCAROLYN MARYAM MOODYCredential: LCSW
Location Address36 CHESTNUT AVE, #5553South San Francisco, CA 94083-8074
Mailing AddressPo Box 5553South San Francisco, CA 94083-5553
Phone(415) 200-4587
Sole ProprietorYes
Enumeration DateAugust 29, 2014
Last NPPES UpdateJuly 21, 2020
NPPES CertifiedJuly 21, 2020
✔ NPI 1093115867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
36 CHESTNUT AVE, South San Francisco, CA 94083
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carolyn Maryam Moody Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Carolyn Maryam Moody reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
8.8 mi
Internal Medicine
2238 GEARY
San Francisco, CA 94116
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1841373800 (415) 833-2200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94083 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $69.00 – $202.35
Typical copayment $0.00 (range $17.25 – $50.58)
Most-billed visit code NA
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carolyn Maryam Moody's NPI number?

The NPI number for Carolyn Maryam Moody is 1093115867. It was assigned to this individual provider in the NPPES registry on August 29, 2014.

Where is Carolyn Maryam Moody located?

Carolyn Maryam Moody practices at 36 Chestnut Ave #5553, South San Francisco, CA 94083. The listed phone number is (415) 200-4587.

What is Carolyn Maryam Moody's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Carolyn Maryam Moody enrolled in Medicare?

Yes. Carolyn Maryam Moody is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Carolyn Maryam Moody's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carolyn Maryam Moody reassigns Medicare benefits to Permanente Medical Group Inc (San Francisco, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carolyn Maryam Moody's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Carolyn Maryam Moody was last updated on July 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.