NPIMap

Organization Active NPI

Eldercare Services Institute,LLC

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1689799561
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ELDERCARE SERVICES INSTITUTE,LLC
Practice address
11890 Fairhill Rd
Cleveland, OH 44120-1053
Phone
(216) 373-1605
Fax
(216) 373-1812
NPI assigned
Mar 20, 2007
Organization subpart
Yes
Parent organization
BENJAMIN ROSE INSTITUTEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Authorized official

Name
Ms. Janice Brennan, CPA
Title
Cfo, Vice President of Finance
Phone
(216) 373-1605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

11890 Fairhill Rd
Cleveland, OH 44120-1053

Mailing address

11890 Fairhill Rd
Cleveland, OH 44120-1053
Phone (216) 373-1605

Other identifiers 3

IdentifierTypeStateIssuer
12834OtherOHCCCMHB UPIN
2871165OtherOHMEDICAID X-OVERS (ODJFS)
EL9375361OtherOHMEDICARE B PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080515000267 OH Part B Supplier - Clinic/Group Practice 4789762840 Receives reassigned benefits from 3 practitioners
Practice locations: Cleveland, OH

National Provider Directory

National Provider Directory
Tax ID family
Benjamin Rose Institute3 organizations share this tax ID, including this one
Part of
Benjamin Rose Institute

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1689799561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11890 FAIRHILL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201053",
            "telephone_number": "216-373-1605",
            "fax_number": "216-373-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11890 FAIRHILL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201053",
            "telephone_number": "216-373-1605",
            "fax_number": "216-373-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERCARE SERVICES INSTITUTE,LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BENJAMIN ROSE INSTITUTE",
        "enumeration_date": "2007-03-20",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "CFO, VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "216-373-1605",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCCMHB UPIN",
            "identifier": "12834",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID X-OVERS (ODJFS)",
            "identifier": "2871165",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B PTAN",
            "identifier": "EL9375361",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.