Individual provider Active NPI

Edgar Anthony Tsamasiros, BSW LISCENSED SOCAIL

  • Social Worker
  • Dayton, OH
National Provider Identifier
1073004206
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.1802338 Issued in OH
Practice address
732 Beckman St
Dayton, OH 45410-2165
Phone
(937) 253-1680
NPI assigned
May 23, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2018

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 S.1802338 OH Primary

Addresses

Primary practice location

732 Beckman St
Dayton, OH 45410-2165

Mailing address

100 Maple Gardens Dr
Union, OH 45322-3235
Phone (937) 718-3091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.1802338OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Behavioral Health, Inc. Past Accepting new patients
Nova Behavioral Health, Inc PastSince Dec 1, 2016 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1073004206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAPLE GARDENS DR",
            "city": "UNION",
            "state": "OH",
            "postal_code": "453223235",
            "telephone_number": "937-718-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 BECKMAN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454102165",
            "telephone_number": "937-253-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSAMASIROS",
        "first_name": "EDGAR",
        "middle_name": "ANTHONY",
        "credential": "BSW LISCENSED SOCAIL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1802338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.