Individual provider Active NPI

Rebecca Anne Kiersznowski, MSW, CCDC, CCDP-D

  • Clinical Social Worker
  • Elkton, MD
National Provider Identifier
1437201019
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11752 Issued in MD
Practice address
200 Booth St
Elkton, MD 21921-5657
Phone
(410) 996-5104
Fax
(410) 996-5197
NPI assigned
Jan 17, 2007
Last updated
Apr 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1445 MD
Clinical Social Worker 1041C0700X 11752 MD Primary

Addresses

Primary practice location

200 Booth St
Elkton, MD 21921-5657

Mailing address

305 Main St.
PO Box 294
Townsend, DE 19734
Phone (410) 996-5104

Other names 1

  • Rebecca Anne Arbogast Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20100927000522 MD Practitioner - Clinical Social Worker 9739205832 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Hospital of Cecil CountyGroup PAC ID 6901719822, 281 clinicians

Practice addresses (Care Compare)

111 W High St
Suite 204
Elkton, MD 21921-8611
Phone (410) 620-0008

Merit-based Incentive Payment System (MIPS)

Final score
78.57 of 100Reported as group
Quality
59.34
Promoting interoperability
89
Improvement activities
40
Cost
75.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1445MDMDPsychologist
11752MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Bay Counseling and Support Services, Inc CurrentSince May 24, 1999 Accepting new patients
Upper Bay Counseling & Support Services, Inc. Current Accepting new patients
Union Hospital of Cecil County CurrentSince Jul 22, 2019 Accepting new patients

Locations

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

111 W High St
Ste 204
Elkton, MD 21921
Phone (410) 392-3007

200 Booth St
Elkton, MD 21921
Phone (410) 996-3400

Organizations & group practices 4

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1437201019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 MAIN ST.",
            "address_2": "PO BOX 294",
            "city": "TOWNSEND",
            "state": "DE",
            "postal_code": "19734",
            "telephone_number": "410-996-5104",
            "fax_number": "410-996-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BOOTH ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215657",
            "telephone_number": "410-996-5104",
            "fax_number": "410-996-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERSZNOWSKI",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "credential": "MSW, CCDC, CCDP-D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "1445",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "ARBOGAST",
            "middle_name": "ANNE",
            "credential": "MSW, CCDC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elkton, MD

Sources for this page

Verify at the official NPI Registry.