Individual provider Active NPI

Jason Maroudis, LMSW

  • Clinical Social Worker
  • Livonia, MI
National Provider Identifier
1174954531
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801088373 Issued in MI
Practice address
31500 Schoolcraft Rd
Livonia, MI 48150-1805
Phone
(734) 422-9340
Fax
(734) 422-9353
NPI assigned
Dec 10, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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 6801088373 MI Primary

Addresses

Primary practice location

31500 Schoolcraft Rd
Livonia, MI 48150-1805

Mailing address

6549 Town Center Dr
Suite a
Clarkston, MI 48346-4824
Phone (248) 620-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20140225001678 MI Practitioner - Clinical Social Worker 9537399258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ismail B Sendi MD PCGroup PAC ID 4688674534, 72 clinicians

Practice addresses (Care Compare)

13305 Reeck CT
Southgate, MI 48195-3197
Phone (800) 395-3223

31500 Schoolcraft Rd
Livonia, MI 48150-1805
Phone (800) 395-3223

6549 Town Ctr Dr
Clarkston, MI 48346-4824
Phone (800) 395-3223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ismail B. Sendi, MD, PC CurrentSince Dec 23, 2013 Accepting new patients
Ismail B. Sendi, MD, PC CurrentSince Dec 23, 2013 Accepting new patients

Locations

6549 Town Center Dr
Ste A
Clarkston, MI 48346
Phone (248) 620-6400

31500 Schoolcraft Rd
Livonia, MI 48150
Phone (734) 422-9340

13305 Reeck Ct
Southgate, MI 48195
Phone (734) 225-2090

Organizations & group practices 2

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": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1174954531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6549 TOWN CENTER DR",
            "address_2": "SUITE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464824",
            "telephone_number": "248-620-6400",
            "fax_number": "248-620-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31500 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501805",
            "telephone_number": "734-422-9340",
            "fax_number": "734-422-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAROUDIS",
        "first_name": "JASON",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-10",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.