Individual provider Active NPI

Annette Cassidy, CSW

  • Clinical Social Worker
  • Crown Point, IN
National Provider Identifier
1235188517
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34003704 Issued in IN
Practice address
2100 N Main St Ste 304
Crown Point, IN 46307-1877
Phone
(574) 546-1900
NPI assigned
May 6, 2006
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 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 34003704 IN Primary

Addresses

Primary practice location

2100 N Main St Ste 304
Crown Point, IN 46307-1877

Mailing address

2100 N Main St Ste 304
Crown Point, IN 46307-1877
Phone (574) 546-1900

Other practice location 1

403 E Madison St
South Bend, IN 46617-2322
Phone (574) 283-1107

Other practice location 2

21 E State St
Columbus, OH 43215-4281
Phone (574) 546-1900

Other names 1

  • Annette Cook Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160506001166 IN Practitioner - Clinical Social Worker 1254630643 Reassigns benefits to 1 organization
I20230106001798 OH Practitioner - Clinical Social Worker 1254630643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guidestar Eldercare Corp -OhGroup PAC ID 9739504523, 43 clinicians
Neurology and Pain Management Associates PCGroup PAC ID 4486676095, 86 clinicians

Practice addresses (Care Compare)

199 Rd
Suite 103
Paulding, OH 45879-8776
Phone (574) 546-1900

2100 N Main St
Suite 304
Crown Point, IN 46307-1877
Phone (574) 546-1900

990 Bayley Dr
Cincinnati, OH 45233-1664
Phone (574) 546-1900

Merit-based Incentive Payment System (MIPS)

Final score
93.06 of 100Reported as group
Quality
80.07
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as group
Quality
79.89
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34003704INMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology and Pain Management Associates PC Clinical CurrentSince Aug 1, 2018 Accepting new patients
Guidestar Eldercare Corp -Oh Clinical CurrentSince Dec 19, 2022 Accepting new patients

Locations

990 Bayley Dr
Cincinnati, OH 45233
Phone (513) 347-5500

21 E State St
Columbus, OH 43215
Phone (574) 546-1999

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1235188517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N MAIN ST STE 304",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071877",
            "telephone_number": "574-546-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N MAIN ST STE 304",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071877",
            "telephone_number": "574-546-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 E Madison St",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466172322",
            "country_code": "US",
            "telephone_number": "574-283-1107",
            "fax_number": "574-283-1131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 E State St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154281",
            "country_code": "US",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "ANNETTE",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-06",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNETTE",
            "last_name": "COOK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.