Derek Doss

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

960 Boardman Canfield Rd
Boardman, OH 44512-4220

Phone

(330) 259-8813

Fax

(330) 270-2690

NPI assigned

Sep 21, 2017

Reactivated

Nov 8, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Starz Counseling, LLCGroup PAC ID 3779934120, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Starz Counseling, LLC

  • Clinical Social Worker
  • Austintown, OH
  • NPI 1720766975
  Medicare reassignment Care Compare group NPD
• Churchill Counseling Services, Inc

  • Mental Health Counselor
  • Youngstown, OH
  • NPI 1013996271
  Medicare reassignment NPD
• Trumbull Mahoning Medical Group, Inc.

  • Internal Medicine Physician
  • Youngstown, OH
  • NPI 1538353883
  NPD (past)

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1336658301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5760 PATRIOT BLVD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445151170",
            "telephone_number": "330-259-8813",
            "fax_number": "330-953-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124220",
            "telephone_number": "330-259-8813",
            "fax_number": "330-270-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOSS",
        "first_name": "DEREK",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-21",
        "last_updated": "2023-11-08",
        "certification_date": "2020-10-06",
        "deactivation_date": "2023-10-26",
        "reactivation_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Boardman, OH
• Providers in Boardman, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.