Individual provider Active NPI

Nichole Maria Budosh, LCSW

  • Clinical Social Worker
  • Seven Fields, PA
National Provider Identifier
1477063535
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
100 Northpointe Cir Ste 306
Seven Fields, PA 16046-7851
Phone
(724) 772-4848
NPI assigned
Oct 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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 PA Primary

Addresses

Primary practice location

100 Northpointe Cir Ste 306
Seven Fields, PA 16046-7851

Mailing address

100 Northpointe Cir Ste 306
Seven Fields, PA 16046-7851
Phone (724) 772-4848

Other identifiers 1

IdentifierTypeStateIssuer
25-0974320MedicaidPA

Other names 1

  • Nichole Maria Roessler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20201006000605 PA Practitioner - Clinical Social Worker 5890114128 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cranberry Psychological Center, Inc.Group PAC ID 3072501626, 45 clinicians

Practice addresses (Care Compare)

100 Northpointe Cir
Suite 306
Seven Fields, PA 16046-7851
Phone (724) 772-4848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cranberry Psychological Center, Inc. Professional CurrentSince Dec 4, 2021 Accepting new patients
Upmc Presbyterian Shadyside CurrentSince Sep 15, 2020 Accepting new patients
Upmc Presbyterian Shadyside CurrentSince Sep 15, 2020 Accepting new patients

Locations

100 N Bellefield Ave
Ste 6
Pittsburgh, PA 15213
Phone (412) 246-5222

1011 Bingham St
Pittsburgh, PA 15203
Phone (412) 235-5300

3811 Ohara St
Pittsburgh, PA 15213
Phone (412) 624-2000

100 Northpointe Cir
Ste 306
Seven Fields, PA 16046
Phone (724) 772-4848

Organizations & group practices 3

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": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1477063535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORTHPOINTE CIR STE 306",
            "city": "SEVEN FIELDS",
            "state": "PA",
            "postal_code": "160467851",
            "telephone_number": "724-772-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTHPOINTE CIR STE 306",
            "city": "SEVEN FIELDS",
            "state": "PA",
            "postal_code": "160467851",
            "telephone_number": "724-772-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDOSH",
        "first_name": "NICHOLE",
        "middle_name": "MARIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25-0974320",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "ROESSLER",
            "middle_name": "MARIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seven Fields, PA

Sources for this page

Verify at the official NPI Registry.