Individual provider Active NPI

Conor D. Monaghan

  • Clinical Social Worker
  • Mentor, OH
National Provider Identifier
1497327571
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2203575 Issued in OH
Practice address
7232 Justin Way
Mentor, OH 44060-4881
Phone
(440) 578-8200
NPI assigned
Jul 16, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S.1903417 OH
Clinical Social Worker 1041C0700X I.2203575 OH Primary

Addresses

Primary practice location

7232 Justin Way
Mentor, OH 44060-4881

Mailing address

7232 Justin Way
Mentor, OH 44060-4881
Phone (440) 578-8200

Other identifiers 1

IdentifierTypeStateIssuer
0452242MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20220531000461 OH Practitioner - Clinical Social Worker 2567840739 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.2203575OHMDClinical Social Worker
S.1903417OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Health, Inc CurrentSince Apr 18, 2022 Accepting new patients
Signature Health Inc CurrentSince Apr 18, 2022 Accepting new patients
Signature Health, Inc. Current Accepting new patients

Locations

21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

38876 Mentor Ave
Willoughby, OH 44094
Phone (440) 954-3333

38882 Mentor Ave
Willoughby, OH 44094

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": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1497327571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7232 JUSTIN WAY",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604881",
            "telephone_number": "440-578-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7232 JUSTIN WAY",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604881",
            "telephone_number": "440-578-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONAGHAN",
        "first_name": "CONOR",
        "middle_name": "D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-16",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1903417",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2203575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0452242",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.