SQUARE MEDICAL GROUP LLC
NPI 1760957609
Clinic/Center - Mental Health (Including Community Mental Health Center) in Watertown, MA

NPI Status: Active since October 08, 2018

Contact Information

124 WATERTOWN ST STE 2D
WATERTOWN, MA
ZIP 02472
Phone: (617) 916-5069

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Clinic/Center
Mental Health (Including Community Menta...
Accepts Insurance
CLIA Number: 22D2236133
CLIA Cert. Type: Other - RECOVERY HOME FOR SUD
CLIA Exp. Date: 09-14-2027

About SQUARE MEDICAL GROUP LLC

This page provides the complete NPI Profile along with additional information for Square Medical Group Llc, a provider established in Watertown, Massachusetts operating as a Clinic/center, focusing in mental health (including community mental health center) . The healthcare provider is registered in the NPI registry with number 1760957609 assigned on October 2018. The practitioner's primary taxonomy code is 261QM0801X. The provider is registered as an organization and their NPI record was last updated 8 years ago. The authorized official of this NPI record is Jeff Gershman (Ceo)

NPI: 1760957609
Provider Name: SQUARE MEDICAL GROUP LLC
Entity Type: Organization
Location Address: 124 WATERTOWN ST STE 2D WATERTOWN, MA 02472
Location Phone: (617) 916-5069
Mailing Address: 124 WATERTOWN ST STE 2D WATERTOWN, MA 02472
Mailing Phone: (617) 916-5069
Is Sole Proprietor?: No
Is Organization Subpart?: Yes
Enumeration Date: 10-08-2018
Last Update Date: 10-08-2018
Code Navigator

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Clinic/Center Mental Health (Including Community Mental Health Center)
Taxonomy Code: 261QM0801X
Type: Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Anthem Blue Cross and Blue Shield

Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
Anthem Gold Access Blue New England HMO 3000/0%/7500 RxD - HMO
Anthem Gold Access Blue New England HMO 500/30%/9000 - HMO
Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
Anthem Silver Access Blue New England HMO 2500/30%/10000 Value - HMO
Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
Anthem Silver Access Blue New England HMO 3500/20%/10000 - HMO
Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
Anthem Silver Access Blue New England HMO 4000/0%/9000 - HMO
Anthem Silver Access Blue New England HMO 4000/0%/9000 RxD - HMO
Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
Anthem Silver Access Blue New England HMO 4000/20%/8500 - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: JEFF GERSHMAN
Authorized Official Title: CEO
Authorized Official Phone: (617) 916-5069

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 22D2236133
Facility Type: Other - RECOVERY HOME FOR SUD
Certificate Effective Date: September 15, 2025
Certificate Expiration Date: September 14, 2027
Laboratory Director: NATALIE L. LENDER
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Square Medical Group Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1760957609, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 12 → 1 + 2

Pos 4

Unchanged

Pos 5

Doubled → 18 → 1 + 8

Pos 6

Unchanged

Pos 7

Doubled → 14 → 1 + 4

Pos 8

Unchanged

Pos 9

Doubled → 0

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 9 → 18 → 9 7 → 14 → 5 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 2 + 0 + 1 + 8 + 5 + 1 + 4 + 6 + 0 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9

This NPI is valid

The calculated check digit is 9, which matches the last digit of 1760957609.