Individual provider Active NPI

Roxanne Cavataio, LCSW

  • Clinical Social Worker
  • Gulfport, MS
National Provider Identifier
1285733329
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C3900 Issued in MS
Practice address
1403 43Rd Ave
Gulfport, MS 39501
Phone
(228) 861-5260
Fax
(228) 241-0326
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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 C3900 MS Primary

Addresses

Primary practice location

1403 43Rd Ave
Gulfport, MS 39501

Mailing address

PO Box 4456
Bay Saint Louis, MS 39521-4456
Phone (228) 861-5260

Other identifiers 1

IdentifierTypeStateIssuer
00117751MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20050307000225 MS Practitioner - Clinical Social Worker 9133173792 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

Practice addresses (Care Compare)

1403 43Rd Ave
Gulfport, MS 39501-2545
Phone (228) 861-5260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Roxanne Cavataio, LCSW, PLLC Clinical CurrentSince Sep 10, 2018 Accepting new patients

Locations

1403 43rd Ave
Gulfport, MS 39501
Phone (228) 861-5260

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1285733329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4456",
            "city": "BAY SAINT LOUIS",
            "state": "MS",
            "postal_code": "395214456",
            "telephone_number": "228-861-5260",
            "fax_number": "228-241-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 43RD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-861-5260",
            "fax_number": "228-241-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVATAIO",
        "first_name": "ROXANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C3900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00117751",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.