Individual provider Active NPI

Mansi P NG, LISW-SUPV

  • Clinical Social Worker
  • Pepper Pike, OH
National Provider Identifier
1033426994
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1100134-SUPV Issued in OH
Practice address
3737 Lander Rd
Pepper Pike, OH 44124-5712
Phone
(216) 831-2255
Fax
(216) 378-3906
NPI assigned
Sep 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S.0900807 OH
Clinical Social Worker 1041C0700X I.1100134 OH
Clinical Social Worker 1041C0700X I.1100134-SUPV OH Primary

Addresses

Primary practice location

3737 Lander Rd
Pepper Pike, OH 44124-5712

Mailing address

11801 Buckeye Rd
Cleveland, OH 44120-2620
Phone (216) 831-2255

Other identifiers 1

IdentifierTypeStateIssuer
0268768MedicaidOH

Other names 1

  • Mansi P Desai Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240320004021 OH Practitioner - Clinical Social Worker 2264879659 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1100134OHMDClinical Social Worker
I.1100134-SUPVOHMDClinical Social Worker
S.0900807OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Feb 8, 2024 Accepting new patients
Beech Brook Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197

Organizations & group practices 2

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": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1033426994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11801 BUCKEYE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202620",
            "telephone_number": "216-831-2255",
            "fax_number": "216-378-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 LANDER RD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245712",
            "telephone_number": "216-831-2255",
            "fax_number": "216-378-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG",
        "first_name": "MANSI",
        "middle_name": "P",
        "credential": "LISW-SUPV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.0900807",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1100134",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1100134-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0268768",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANSI",
            "last_name": "DESAI",
            "middle_name": "P",
            "credential": "LISW-SUPV",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pepper Pike, OH

Sources for this page

Verify at the official NPI Registry.