Individual provider Active NPI

Jania Y Ross

  • Clinical Social Worker
  • Windsor, CT
National Provider Identifier
1366159584
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12719 Issued in CT
Practice address
56 Poquonock Ave
Windsor, CT 06095-2507
Phone
(475) 261-0459
Fax
(252) 484-6046
NPI assigned
Oct 28, 2022
Last updated
May 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5818 CT
Clinical Social Worker 1041C0700X 12719 CT Primary

Addresses

Primary practice location

56 Poquonock Ave
Windsor, CT 06095-2507

Mailing address

56 Poquonock Ave
Windsor, CT 06095-2507
Phone (475) 261-0459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240411000363 CT Practitioner - Clinical Social Worker 7911345889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

56 Poquonock Ave
Windsor, CT 06095-2507
Phone (475) 261-0459

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5818CTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways to Perseverance LLC Clinical CurrentSince Jan 25, 2024 Accepting new patients
T.R.U.E. Self Counseling Clinical PastSince Oct 1, 2022 Accepting new patients

Locations

56 Poquonock Ave
Windsor, CT 06095
Phone (475) 261-0459

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1366159584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 POQUONOCK AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952507",
            "telephone_number": "475-261-0459",
            "fax_number": "252-484-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 POQUONOCK AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952507",
            "telephone_number": "475-261-0459",
            "fax_number": "252-484-6046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JANIA",
        "middle_name": "Y",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-28",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "5818",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "12719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CT

Sources for this page

Verify at the official NPI Registry.