Individual provider Active NPI

Stacey Hilts Rosas, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1275824591
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
51816 Issued in TX
Practice address
5224 Moon Shadow Dr
Austin, TX 78735-6015
Phone
(512) 587-1107
Fax
(866) 587-1655
NPI assigned
Apr 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2023

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 51816 TX Primary

Addresses

Primary practice location

5224 Moon Shadow Dr
Austin, TX 78735-6015

Mailing address

5224 Moon Shadow Dr
Austin, TX 78735-6015
Phone (512) 587-1107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110727000315 TX Practitioner - Clinical Social Worker 0244408763 Reassigns benefits to 1 organization
Practice locations: Austin, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5224 Moon Shadow Dr
Austin, TX 78735-6015
Phone (512) 587-1107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stacey Rosas LCSW PLLC Clinical CurrentSince Mar 10, 2020 Accepting new patients

Locations

4425 S Mopac Expy
Ste 102
Austin, TX 78735
Phone (512) 407-8766

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": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1275824591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5224 MOON SHADOW DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787356015",
            "telephone_number": "512-587-1107",
            "fax_number": "866-587-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5224 MOON SHADOW DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787356015",
            "telephone_number": "512-587-1107",
            "fax_number": "866-587-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSAS",
        "first_name": "STACEY",
        "middle_name": "HILTS",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-20",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "51816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.