Individual provider Active NPI

Rosemarie Dorn, LCSW

  • Social Worker
  • Perrysburg, NY
National Provider Identifier
1396875381
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
0751211 Issued in NY
Practice address
10714 North Rd
Perrysburg, NY 14129-9746
Phone
(716) 532-1049
Fax
(716) 532-0679
NPI assigned
Mar 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 0751211 NY Primary

Addresses

Primary practice location

10714 North Rd
Perrysburg, NY 14129-9746

Mailing address

10709 Leon Rd
Cattaraugus, NY 14719-9767
Phone (716) 257-5106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20231130001969 NY Order and Referring Only - Clinical Social Worker 0244210631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0751211NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office PastSince Jan 13, 2010 Accepting new patients

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, 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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396875381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10709 LEON RD",
            "city": "CATTARAUGUS",
            "state": "NY",
            "postal_code": "147199767",
            "telephone_number": "716-257-5106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10714 NORTH RD",
            "city": "PERRYSBURG",
            "state": "NY",
            "postal_code": "141299746",
            "telephone_number": "716-532-1049",
            "fax_number": "716-532-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORN",
        "first_name": "ROSEMARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "0751211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, NY

Sources for this page

Verify at the official NPI Registry.