Individual provider Active NPI

Roseann D'Agati, LISW-SUPV

  • Clinical Social Worker
  • Pepper Pike, OH
National Provider Identifier
1124324397
Registry record updated Feb 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0008136-SUPV Issued in OH
Practice address
3737 Lander Rd
Pepper Pike, OH 44124-5712
Phone
(216) 831-2255
Fax
(216) 378-3906
NPI assigned
Feb 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 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.0008136-SUPV OH Primary

Addresses

Primary practice location

3737 Lander Rd
Pepper Pike, OH 44124-5712

Mailing address

3737 Lander Rd
Pepper Pike, OH 44124-5712
Phone (216) 831-2255

Other identifiers 1

IdentifierTypeStateIssuer
0268768MedicaidOH

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
I20200123003224 OH Practitioner - Clinical Social Worker 5496180226 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deer Oaks Mental Health Associates PCGroup PAC ID 2264337013, 55 clinicians

Practice addresses (Care Compare)

5200 Marymount Village Dr
Garfield Heights, OH 44125-2973
Phone (888) 365-6271

Merit-based Incentive Payment System (MIPS)

Final score
91.16 of 100Reported as group
Quality
80.99
Improvement activities
40
Cost
72.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0008136-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
360Team Counseling LLC Clinical CurrentSince May 4, 2021 Accepting new patients
Jones-Wood Psychological Associates, Inc. CurrentSince Nov 15, 2021 Accepting new patients
Deer Oaks Mental Health Associates PC CurrentSince Oct 1, 2024 Accepting new patients
Laurelwood Associates Inc Past Accepting new patients

Locations

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

9826 Washington St
Chagrin Falls, OH 44023
Phone (440) 708-0188

5200 Marymount Village Dr
Garfield Heights, OH 44125
Phone (216) 332-1070

740 Commerce Dr
Ste A
Perrysburg, OH 43551
Phone 24852821166

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

Organizations & group practices 4

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": "1296777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296777600000",
    "number": "1124324397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": "D'AGATI",
        "first_name": "ROSEANN",
        "credential": "LISW-SUPV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-04",
        "last_updated": "2011-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0008136-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0268768",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pepper Pike, OH

Sources for this page

Verify at the official NPI Registry.