Individual provider Active NPI

Mario Alberto Ramirez

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1487102091
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW114245 Issued in CA
Practice address
679 S New Hampshire Ave
Los Angeles, CA 90005-1355
Phone
(626) 294-1079
NPI assigned
Sep 13, 2016
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW11424 CA
Clinical Social Worker 1041C0700X LCSW114245 CA Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

679 S New Hampshire Ave
Los Angeles, CA 90005-1355

Mailing address

505 S Ferris Ave
Los Angeles, CA 90022-1901
Phone (323) 594-5201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230710002509 CA Practitioner - Clinical Social Worker 4688033517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific ClinicsGroup PAC ID 4082008420, 72 clinicians

Practice addresses (Care Compare)

679 S New Hampshire Ave
Suite 400
Los Angeles, CA 90005-1355
Phone (213) 639-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW11424CAMDClinical Social Worker
LCSW114245CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics CurrentSince May 21, 2023 Accepting new patients
Pacific Clinics Current Accepting new patients
Pacific Clinics CurrentSince May 21, 2023 Accepting new patients

Locations

251 Llewellyn Ave
Campbell, CA 95008
Phone (408) 364-4083

679 S New Hampshire Ave
Ste 400
Los Angeles, CA 90005
Phone (213) 639-2500

1020 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 403-2794

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, 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": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1487102091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S FERRIS AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221901",
            "telephone_number": "323-594-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 S NEW HAMPSHIRE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051355",
            "telephone_number": "626-294-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ",
        "first_name": "MARIO",
        "middle_name": "ALBERTO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-13",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW11424",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW114245",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.