Individual provider Active NPI

Andrew Masters

  • Clinical Social Worker
  • Toledo, OH
National Provider Identifier
1134633217
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1500897 Issued in OH
Practice address
2005 Ashland Ave
Toledo, OH 43620-1703
Phone
(419) 841-7701
NPI assigned
Nov 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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 1500897 OH Primary

Addresses

Primary practice location

2005 Ashland Ave
Toledo, OH 43620-1703

Mailing address

2005 Ashland Ave
Toledo, OH 43620-1703

Other practice location 1

111 Clinton Street
Maumee, OH 43537-2811
Phone (419) 740-3022

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
I20180514000435 OH Practitioner - Clinical Social Worker 2567726888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Vital Health LLCGroup PAC ID 4486048634, 2 clinicians

Practice addresses (Care Compare)

111 Clinton St
Maumee, OH 43537-2811
Phone (419) 740-3022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1500897OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Vital Health LLC CurrentSince Aug 12, 2024 Accepting new patients
Vital Health LLC CurrentSince Aug 12, 2024 Accepting new patients
Vital Health LLC Past Accepting new patients

Locations

111 Clinton St
Maumee, OH 43537
Phone (419) 740-3022

Organizations & group practices 3

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": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1134633217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 ASHLAND AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436201703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 ASHLAND AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436201703",
            "telephone_number": "419-841-7701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Clinton Street",
            "address_purpose": "LOCATION",
            "city": "Maumee",
            "state": "OH",
            "postal_code": "435372811",
            "country_code": "US",
            "telephone_number": "419-740-3022",
            "fax_number": "419-740-3033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTERS",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-28",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "1500897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.