Individual provider Active NPI

Kevin M. Rico, LCSW

  • Clinical Social Worker
  • Irwin, PA
National Provider Identifier
1154318368
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW013643 Issued in PA
Practice address
624 Main St
Irwin, PA 15642-3407
Phone
(724) 863-0226
Fax
(724) 863-0226
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

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 CW013643 PA Primary

Addresses

Primary practice location

624 Main St
Irwin, PA 15642-3407

Mailing address

1720 Melrose Ave
Irwin, PA 15642-3911
Phone (724) 863-3539

Other identifiers 8

IdentifierTypeStateIssuer
001914725OtherPACOMMUNITY CARE BEHAVIORAL
104639OtherPAUNITED BEHAVIORAL HEALTH
324665OtherPAUPMC INSURANCE
454660OtherPAVALUE OPTIONS
559672OtherPABLUE CROSS BLUE SHIELD
454660OtherPAVALUE BEHAVIORAL HEALTH
559672OtherPAMAGELLAN INSURANCE
0019147250001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20060629000307 PA Practitioner - Clinical Social Worker 7113939596 Practice locations: Irwin, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

624 Main St
Irwin, PA 15642-3431
Phone (724) 863-0226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1154318368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 MELROSE AVE",
            "city": "IRWIN",
            "state": "PA",
            "postal_code": "156423911",
            "telephone_number": "724-863-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 MAIN ST",
            "city": "IRWIN",
            "state": "PA",
            "postal_code": "156423407",
            "telephone_number": "724-863-0226",
            "fax_number": "724-863-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICO",
        "first_name": "KEVIN",
        "middle_name": "M.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW013643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY CARE BEHAVIORAL",
            "identifier": "001914725",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "104639",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC INSURANCE",
            "identifier": "324665",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "454660",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "559672",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE BEHAVIORAL HEALTH",
            "identifier": "454660",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN INSURANCE",
            "identifier": "559672",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019147250001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irwin, PA

Sources for this page

Verify at the official NPI Registry.