Individual provider Active NPI

Nicholas Stephen Rossy

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1104475649
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2203512 Issued in OH
Practice address
2621 Victory Pkwy
Cincinnati, OH 45206-1754
Phone
(513) 221-4673
NPI assigned
Sep 7, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1903920 OH
Clinical Social Worker 1041C0700X I.2203512 OH Primary

Addresses

Primary practice location

2621 Victory Pkwy
Cincinnati, OH 45206-1754

Mailing address

2621 Victory Pkwy
Cincinnati, OH 45206-1754
Phone (513) 221-4673

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
I20220608000937 OH Practitioner - Clinical Social Worker 6002294741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

25101 Chagrin Blvd
Suite 100
Beachwood, OH 44122-5694
Phone (216) 831-6611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1903920OHMDSocial Worker
I.2203512OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC Clinical CurrentSince Jun 1, 2022 Accepting new patients

Locations

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122
Phone (216) 245-4468

25101 Chagrin Blvd
Ste 200
Beachwood, OH 44122
Phone (216) 273-8127

25111 Country Club Blvd
Ste 290
North Olmsted, OH 44070
Phone (440) 614-2520

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": "1567814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1104475649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 VICTORY PKWY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061754",
            "telephone_number": "513-221-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 VICTORY PKWY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061754",
            "telephone_number": "513-221-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSY",
        "first_name": "NICHOLAS",
        "middle_name": "STEPHEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-07",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "1903920",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2203512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.