Individual provider Active NPI

Rebecca Pilarzyk, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1447760087
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15959 Issued in MN
Practice address
1100 Glenwood Ave
Minneapolis, MN 55405-1430
Phone
(612) 616-0164
Fax
(612) 616-0164
NPI assigned
Oct 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 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 15959 MN Primary

Addresses

Primary practice location

1100 Glenwood Ave
Minneapolis, MN 55405-1430

Mailing address

2501 Upton Ave N
Minneapolis, MN 55411-1712
Phone (612) 616-0164

Other practice location 1

13400 Staring Lake Pkwy
Eden Prairie, MN 55347-1800
Phone (612) 271-0913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20180112001544 MN Practitioner - Clinical Social Worker 0143589465 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gillette Children'S Specialty Healthcare CurrentSince Jul 10, 2023 Accepting new patients
Fairview Express Care CurrentSince Dec 8, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Dec 8, 2019 Accepting new patients
Gillette Children'S Specialty Healthcare CurrentSince Jul 10, 2023 Accepting new patients

Locations

1405 Lilac Dr N
Ste 151
Minneapolis, MN 55422
Phone (763) 525-9919

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

200 University Ave E
Saint Paul, MN 55101
Phone (651) 291-2848

Organizations & group practices 6

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": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1447760087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 UPTON AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554111712",
            "telephone_number": "612-616-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GLENWOOD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051430",
            "telephone_number": "612-616-0164",
            "fax_number": "612-616-0164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13400 Staring Lake Pkwy",
            "address_purpose": "LOCATION",
            "city": "Eden Prairie",
            "state": "MN",
            "postal_code": "553471800",
            "country_code": "US",
            "telephone_number": "612-271-0913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PILARZYK",
        "first_name": "REBECCA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.