Individual provider Active NPI

Cami L Tiska Caton, LCSW

  • Social Worker
  • Fort Lauderdale, FL
National Provider Identifier
1669605838
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
3800 W Broward Blvd Ste 100
Ft Lauderdale, FL 33312-1018
Phone
(954) 587-1008
Fax
(954) 587-0080
NPI assigned
Sep 3, 2009
Last updated
Feb 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

3800 W Broward Blvd Ste 100
Ft Lauderdale, FL 33312-1018

Mailing address

3800 W Broward Blvd Ste 100
Ft Lauderdale, FL 33312-1018
Phone (954) 587-1008

Other identifiers 1

IdentifierTypeStateIssuer
009-90-3800MedicaidFL

Other names 1

  • Cami Lynn Tiska Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@chrysalishealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240409004909 FL Practitioner - Clinical Social Worker 6103264155 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chrysalis Center, LLC CurrentSince Mar 5, 2024 Accepting new patients

Locations

3800 W Broward Blvd
Ste 100
Ft Lauderdale, FL 33312

3521 W Broward Blvd
Ste 208
Lauderhill, FL 33312

Organizations & group practices 1

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": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1669605838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 W BROWARD BLVD STE 100",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333121018",
            "telephone_number": "954-587-1008",
            "fax_number": "549-789-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 W BROWARD BLVD STE 100",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333121018",
            "telephone_number": "954-587-1008",
            "fax_number": "954-587-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISKA CATON",
        "first_name": "CAMI",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009-90-3800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@chrysalishealth.com",
            "affiliation": "N",
            "address_1": "3800 W Broward Blvd Ste 100",
            "city": "Ft Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333121018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CAMI",
            "last_name": "TISKA",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.