Individual provider Active NPI

Paul Hasenauer

  • Clinical Social Worker
  • Mansfield, OH
National Provider Identifier
1053600338
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-1100050 Issued in OH
Practice address
741 Scholl Rd
Mansfield, OH 44907-1571
Phone
(419) 756-1717
Fax
(419) 756-2594
NPI assigned
Apr 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-1100050 OH Primary

Addresses

Primary practice location

741 Scholl Rd
Mansfield, OH 44907-1571

Mailing address

741 Scholl Rd
Mansfield, OH 44907-1571
Phone (419) 756-1717

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
I20190301002124 OH Practitioner - Clinical Social Worker 3577802990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Center for Individual and Family Services, Inc.Group PAC ID 9133102544, 14 clinicians

Practice addresses (Care Compare)

270 Sterkel Blvd
Mansfield, OH 44907-1508
Phone (419) 756-1717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-1100050OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Individual & Family Services, Inc. CurrentSince Dec 26, 2018 Accepting new patients
The Center for Individual and Family Services, Inc. CurrentSince Dec 26, 2018 Accepting new patients

Locations

741 Scholl Rd
Mansfield, OH 44907
Phone (419) 756-1717

270 Sterkel Blvd
Mansfield, OH 44907
Phone (419) 756-1133

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": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1053600338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 SCHOLL RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071571",
            "telephone_number": "419-756-1717",
            "fax_number": "419-756-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 SCHOLL RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071571",
            "telephone_number": "419-756-1717",
            "fax_number": "419-756-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASENAUER",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-07",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-1100050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.