Carissa Blatz, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.1502481 Issued in OH

Practice address

3030 W Fork Rd
Cincinnati, OH 45211-1944

Phone

(513) 619-2913

NPI assigned

Mar 19, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Resident Home CorporationGroup PAC ID 9537424064, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• The Resident Home Corporation

  • Community/Behavioral Health Agency
  • Cincinnati, OH
  • NPI 1508111410
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521417600000",
    "number": "1609370329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 W FORK RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452111944",
            "telephone_number": "513-619-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 W FORK RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452111944",
            "telephone_number": "513-619-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLATZ",
        "first_name": "CARISSA",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2018-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1502481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Blaszkowski
• Blatman Pain Clinic
• Hal Samuel Blatman, M.D.
• Molly Elizabeth Blatt, CNP
• Stephen Patrick Blatt, MD
• James Blau
• Matthew Blau
• Doctor Micah J'King Blaze, DMD
• Anna Blecha, DO
• Saul Blecher, MD

• Social Worker in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; 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.