Individual provider Active NPI

Melissa Beseres, LICSW

  • Clinical Social Worker
  • Grand Marais, MN
National Provider Identifier
1659077410
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
513 5TH Ave W
Grand Marais, MN 55604-3017
Phone
(218) 387-2330
NPI assigned
Feb 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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 Primary

Addresses

Primary practice location

513 5TH Ave W
Grand Marais, MN 55604-3017

Mailing address

513 5TH Ave W
Grand Marais, MN 55604-3017
Phone (218) 387-2330

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230406000918 MN Practitioner - Clinical Social Worker 8325413214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sawtooth Mountain Clinic IncGroup PAC ID 8224940010, 13 clinicians

Practice addresses (Care Compare)

513 5TH Ave W
Grand Marais, MN 55604-3017
Phone (218) 387-2330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sawtooth Mountain Clinic, Inc. Clinical CurrentSince Feb 20, 2023 Accepting new patients
The Duluth Clinic, LTD. PastSince Feb 8, 2023 Accepting new patients
Northwest Michigan Health Services, Inc. Past Accepting new patients

Locations

513 5th Ave W
Grand Marais, MN 55604
Phone (218) 387-2330

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": "1675382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1659077410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 5TH AVE W",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "556043017",
            "telephone_number": "218-387-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 5TH AVE W",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "556043017",
            "telephone_number": "218-387-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESERES",
        "first_name": "MELISSA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Marais, MN

Sources for this page

Verify at the official NPI Registry.