Individual provider Active NPI

James Tomasevich, LCSW, CADC II

  • Clinical Social Worker
  • Springfield, OR
National Provider Identifier
1013099522
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L7006 Issued in OR
Practice address
3995 Marcola Road
Springfield, OR 97477
Phone
(541) 726-1465
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP00005784 WA
Addiction (Substance Use Disorder) Counselor 101YA0400X 16-R-16 OR
Clinical Social Worker 1041C0700X L7006 OR Primary

Addresses

Primary practice location

3995 Marcola Road
Springfield, OR 97477

Mailing address

3995 Marcola Road
Springfield, OR 97477
Phone (541) 726-1465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180906001193 OR Practitioner - Clinical Social Worker 3476771544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2995 Ryan Dr SE
Suite 200
Salem, OR 97301-5157
Phone (503) 371-7701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16-R-16ORMDAddiction (Substance Use Disorder) Counselor
CP00005784WAMDAddiction (Substance Use Disorder) Counselor
L7006ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
WVP Medical Group, LLC Current Accepting new patients

Locations

2995 Ryan Dr SE
Ste 200
Salem, OR 97301
Phone (503) 371-7701

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/17738/brand/1/csg/1/fhir/r4
  • Direct secure messaging: james.tomasevich.p96@direct.wvp.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1013099522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3995 MARCOLA ROAD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "97477",
            "telephone_number": "541-726-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3995 MARCOLA ROAD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "97477",
            "telephone_number": "541-726-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMASEVICH",
        "first_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "LCSW, CADC II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00005784",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "16-R-16",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.