Ron Joseph Zuchora-Walske, CLINICALSOCIALWORKER

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

24636 Issued in MN

Practice address

5939 Portland Ave South
Minneapolis, MN 55417

Phone

(612) 689-4444

Fax

(612) 254-8244

NPI assigned

Dec 14, 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

Other names 1

• Ron Joseph Zuchora-Walske Professional name

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, 2006

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Diamond Lake Clinic, P.C.

  • Health Service Clinic/Center
  • Minneapolis, MN
  • NPI 1740669498
  Medicare reassignment NPD
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1518140391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5733 14TH AVE SOUTH",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171001",
            "telephone_number": "612-719-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5939 PORTLAND AVE SOUTH",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55417",
            "telephone_number": "612-689-4444",
            "fax_number": "612-254-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCHORA-WALSKE",
        "first_name": "RON",
        "middle_name": "JOSEPH",
        "credential": "CLINICALSOCIALWORKER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-14",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "24636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "642492100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW ADDITIONAL LICENSE #",
            "identifier": "24636",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RON",
            "last_name": "ZUCHORA-WALSKE",
            "middle_name": "JOSEPH",
            "credential": "LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Melody R Zortman, PA-C
• Roman Joseph Zownirowycz, M.D.
• Louisa K Zuba
• Talhah Zubair, MD
• Jahan Lee Zuberi
• Shelley Lynn Zucker, OTR
• Marsha Zuckerman, MSSW
• Megan Zuehlke
• Janet Diane Zukowski, MS, BCBA
• Fizza Zulfiqar, MD

• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.