Individual provider Active NPI

Victoria Elaine Rose

  • Social Worker
  • Dearborn, MI
National Provider Identifier
1023891991
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6851106132 Issued in MI
Practice address
5111 Auto Club Dr
Dearborn, MI 48126-2749
Phone
(248) 536-5085
NPI assigned
Aug 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6851106132 MI Primary

Addresses

Primary practice location

5111 Auto Club Dr
Dearborn, MI 48126-2749

Mailing address

25842 Bridgewood LN Apt 74
Flat Rock, MI 48134-1058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240424003079 MI Practitioner - Clinical Social Worker 2567802507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Easterseals Morc Health Care, IncGroup PAC ID 9830141670, 129 clinicians

Practice addresses (Care Compare)

2399 E Walton Blvd
Auburn Hills, MI 48326-1955
Phone (248) 475-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6851106132MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Easterseals Morc Health Care, Inc. CurrentSince Aug 9, 2024 Accepting new patients
County of Macomb CurrentSince Oct 1, 2024 Accepting new patients
County of Macomb CurrentSince Oct 1, 2024 Accepting new patients

Locations

2399 E Walton Blvd
Auburn Hills, MI 48326
Phone (248) 475-6400

19800 Hall Rd
Clinton Twp, MI 48038
Phone (586) 854-4804

15600 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-8735

43740 N Groesbeck Hwy
Clinton Twp, MI 48036
Phone (586) 469-7229

22170 W 9 Mile Rd
Southfield, MI 48033
Phone (248) 357-8197

Organizations & group practices 3

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": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1023891991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25842 BRIDGEWOOD LN APT 74",
            "city": "FLAT ROCK",
            "state": "MI",
            "postal_code": "481341058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 AUTO CLUB DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262749",
            "telephone_number": "248-536-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "VICTORIA",
        "middle_name": "ELAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851106132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.