Michael Jerome Bausano, SOCIAL WORKER

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801069870 Issued in MI

Practice address

6713 Sunset LN
Canadian Lakes, MI 49346-8832

Phone

(231) 598-0894

NPI assigned

Jan 19, 2017

Last updated

Apr 23, 2019By the provider in NPPES

Sex

Male

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 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

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Resilience North LLC

  • Social Worker
  • Mecosta, MI
  • NPI 1538052014
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1255877965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6713 SUNSET LN",
            "city": "CANADIAN LAKES",
            "state": "MI",
            "postal_code": "493468832",
            "telephone_number": "231-598-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6713 SUNSET LN",
            "city": "CANADIAN LAKES",
            "state": "MI",
            "postal_code": "493468832",
            "telephone_number": "231-598-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUSANO",
        "first_name": "MICHAEL",
        "middle_name": "JEROME",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-19",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801069870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beemer Enterprises Inc (Canadian Lakes Pharmacy)
• James D Biederbeck, PT
• Canadian Lakes Eyecare, P.L.L.C. (Canadian Lakes Eyecare)
• Neita I Dorais, ANP B-C
• Erin Patrece Dressander, M.P.T.

• Clinical Social Worker in Canadian Lakes, MI
• Providers in Canadian Lakes, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.