Individual provider Active NPI

Marissa Romanovitch, MSW

  • Clinical Social Worker
  • Dover, NH
National Provider Identifier
1558700070
Registry record updated Jan 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1991 Issued in NH
Practice address
15 Old Rollinsford Rd
Suite 302
Dover, NH 03820-2868
Phone
(603) 742-9200
NPI assigned
Jun 18, 2013
Last updated
Jan 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2017

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 1991 NH Primary

Addresses

Primary practice location

15 Old Rollinsford Rd
Suite 302
Dover, NH 03820-2868

Mailing address

789 Central Ave
Dover, NH 03820-2526
Phone (603) 742-9200

Other identifiers 1

IdentifierTypeStateIssuer
3106731MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20170206002233 NH Practitioner - Clinical Social Worker 0345523973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

15 Old Rollinsford Rd
Suite 302
Dover, NH 03820-2819
Phone (603) 742-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1991NHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Jan 3, 2017 Accepting new patients
Marissa Romanovitch, PLLC Current Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Jan 3, 2017 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients

Locations

15 Old Rollinsford Rd
Ste 302
Dover, NH 03820
Phone (603) 742-9200

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

Interoperability endpoints

  • Direct secure messaging: romanovitch.marissa.wdh@direct.partners.masshiway.net

Organizations & group practices 4

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": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485475200000",
    "number": "1558700070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-742-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 OLD ROLLINSFORD RD",
            "address_2": "SUITE 302",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202868",
            "telephone_number": "603-742-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANOVITCH",
        "first_name": "MARISSA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-18",
        "last_updated": "2017-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3106731",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.