John O'Brien, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14313 Issued in MN

Practice address

200 W 98TH St
Ste 107
Bloomington, MN 55420-4858

Phone

(612) 968-6097

NPI assigned

Apr 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Abintra Inc.Group PAC ID 0345589859, 5 clinicians

Evolving Woman Enterprises IncGroup PAC ID 0143308502, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Abintra, Inc

  • Clinical Social Worker
  • Bloomington, MN
  • NPI 1518412907
  Medicare reassignment Care Compare group NPD Authorized official
• Evolving Woman Enterprises, Inc.

  • Clinical Social Worker
  • Edina, MN
  • NPI 1013099191
  Medicare reassignment Care Compare group NPD
• Southern Cities Clinic

  • General Practice Physician
  • Faribault, MN
  • NPI 1437218740
  NPD (past)

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1457579427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 98TH ST",
            "address_2": "STE 107",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554204858",
            "telephone_number": "612-968-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 98TH ST",
            "address_2": "STE 107",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554204858",
            "telephone_number": "612-968-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "JOHN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "14313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "689136500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EID",
            "identifier": "205436246",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Nwosu
• Gale G Nyberg, PT
• Karmen Nyberg, OTR/L
• Stefanie L Nyman, PHARMD, MPA
• Paul C Nystrom, M.D.
• Patrick J O'Brien, M.D.
• Angela O'Donnell, CNM, APRN
• Elizabeth Ann O'Leary, M.D., M.H.S.
• Lindsay Ann O'Mahoney, MPT
• Leah Thushara O'Neil

• Clinical Social Worker in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.