Lisa Rotella

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

3733 University Blvd W Ste 209
Jacksonville, FL 32217-2103

Phone

(904) 543-6055

NPI assigned

Apr 21, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Beaches Behavioral Health LLC

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1770955254
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1174943815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6652 EPPING FOREST WAY N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172648",
            "telephone_number": "610-331-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3733 UNIVERSITY BLVD W STE 209",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172103",
            "telephone_number": "904-543-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTELLA",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Mary Rossi, APRN
• Kelsey M Rossi
• Emily Goldberg Rostholder, M.D.
• Damien Joseph Rostorfer, CRNA
• Rotech Oxygen and Medical Equipment Inc
• Grayson Edward Roth
• Julia Roth, PT, DPT, OCS
• Nathan Thomas Roth, M.D.
• Rayna Roth
• Tricia L Roth

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.