SAMUEL WALLACE PELOQUIN LICSW
NPI 1154069045
Social Worker - Clinical in East Providence, RI

Q: What is Samuel Peloquin's NPI number?

The NPI number for Samuel Peloquin is 1154069045. It was assigned to this individual provider in the NPPES registry on May 22, 2022.

Q: What is Samuel Peloquin's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Samuel Peloquin was last updated on April 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.

Active since May 22, 2022PECOS EnrolledAccepts Medicare Assignment

400 MASSASOIT AVE STE 305, EAST PROVIDENCE, RI 02914(401) 499-1043 Get Directions Write a Review

NPPES record last updated: April 30, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 30, 2026, May 22, 2022 (2 updates tracked since 2022).

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About Samuel Wallace Peloquin Licsw NPPES

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

SAMUEL WALLACE PELOQUIN LICSW (NPI 1154069045) is an individual clinical provider in East Providence, Rhode Island, licensed in Rhode Island (ISW023231) and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1154069045

Entity TypeIndividualMale

Primary Taxonomy1041C0700X

Provider Legal NameSAMUEL WALLACE PELOQUINCredential: LICSW

Location Address400 MASSASOIT AVE STE 305East Providence, RI 02914-2012

Mailing Address400 Massasoit Ave Ste 305East Providence, RI 02914-2012 · (401) 499-1043

Phone(401) 499-1043

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateMay 22, 2022

Last NPPES UpdateApril 30, 20262 updates tracked since enumeration

NPPES CertifiedApril 30, 2026

✔ NPI 1154069045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in RI · ISW023231

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.

Also ListedSocial WorkerTaxonomy 104100000X · License ISW03231 (RI)

400 MASSASOIT AVE STE 305, East Providence, RI 02914

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Harvard Pilgrim Health Care, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samuel Wallace Peloquin Licsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3870957723

PECOS Enrollment IDI20230912001378

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02914 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 $58.57 – $177.03

Typical copayment $0.00 (range $14.64 – $44.25)

Most-billed visit code NA

Established Patient

$72.93 typical visit price

range $18.92 – $144.38

Typical copayment $18.23 (range $4.73 – $36.09)

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.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CARA MURPHY PHD

Psychologist (Clinical)