Individual provider Active NPI

Erica Nicolaus, LISW-S

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1245633148
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I 1451025 Issued in OH
Practice address
7502 State Rd
Ste. 3310
Cincinnati, OH 45255-2596
Phone
(513) 624-1240
Fax
(513) 624-1290
NPI assigned
Oct 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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 I 1451025 OH Primary

Addresses

Primary practice location

7502 State Rd
Ste. 3310
Cincinnati, OH 45255-2596

Mailing address

7502 State Rd
Ste. 3310
Cincinnati, OH 45255-2596
Phone (513) 624-1240

Other identifiers 1

IdentifierTypeStateIssuer
0155142MedicaidOH

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
I20151117002019 OH Practitioner - Clinical Social Worker 8921318296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Cincinnati Specialty Care LLCGroup PAC ID 3971907759, 343 clinicians

Practice addresses (Care Compare)

5944 Colerain Ave
Cincinnati, OH 45239-6414
Phone (513) 385-4757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I 1451025OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati, LLC CurrentSince Jan 1, 2016 Accepting new patients
Mercy Health Physicians Cincinnati LLC CurrentSince Jan 1, 2016 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients

Locations

7502 State Rd
Ste 3310
Cincinnati, OH 45255
Phone (513) 233-6480

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

5944 Colerain Ave
Cincinnati, OH 45239
Phone (513) 385-4757

201 Old Bank Rd
Ste 103
Milford, OH 45150
Phone (513) 248-0100

Interoperability endpoints

  • Direct secure messaging: enicolaus203537@direct.bsmhealth.org

Organizations & group practices 4

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": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1245633148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7502 STATE RD",
            "address_2": "STE. 3310",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452552596",
            "telephone_number": "513-624-1240",
            "fax_number": "513-624-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7502 STATE RD",
            "address_2": "STE. 3310",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452552596",
            "telephone_number": "513-624-1240",
            "fax_number": "513-624-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLAUS",
        "first_name": "ERICA",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-06",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 1451025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0155142",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.