Individual provider Active NPI

Gail Roeshman, L.S.W.

  • Social Worker
  • Wynnewood, PA
National Provider Identifier
1245767953
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW132676 Issued in PA
Practice address
1454 Braddock LN
Wynnewood, PA 19096-3103
Phone
(484) 553-7753
NPI assigned
May 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW132676 PA Primary

Addresses

Primary practice location

1454 Braddock LN
Wynnewood, PA 19096-3103

Mailing address

1454 Braddock LN
Wynnewood, PA 19096-3103
Phone (484) 553-7753

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
I20200622000070 PA Practitioner - Clinical Social Worker 5597187591 Reassigns benefits to 1 organization
Practice locations: Wynnewood, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1454 Braddock LN
Wynnewood, PA 19096-3103
Phone (484) 553-7753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW132676PAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Mar 19, 2020 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

3855 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-6300

Organizations & group practices 1

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": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1245767953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 BRADDOCK LN",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963103",
            "telephone_number": "484-553-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 BRADDOCK LN",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963103",
            "telephone_number": "484-553-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESHMAN",
        "first_name": "GAIL",
        "credential": "L.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW132676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.