Individual provider Active NPI

John Caruso

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1700115292
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15571 Issued in MD
Practice address
3455 Wilkens Ave
Ste 308
Baltimore, MD 21229-5214
Phone
(443) 744-0126
NPI assigned
Dec 14, 2009
Last updated
Dec 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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 15571 MD Primary

Addresses

Primary practice location

3455 Wilkens Ave
Ste 308
Baltimore, MD 21229-5214

Mailing address

15101 Parrish Rd
Upperco, MD 21155-9766
Phone (443) 744-0126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20100331000845 MD Practitioner - Clinical Social Worker 0648306449 Reassigns benefits to 1 organization
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15571MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll Health Group, LLC Clinical CurrentSince Mar 17, 2018 Accepting new patients
MD Center for Veterans Education & Training, Inc Past Accepting new patients
MD Center for Veterans Education & Training, Inc PastSince Mar 24, 2025 Accepting new patients

Locations

193 Stoner Ave
Ste 220
Westminster, MD 21157
Phone (410) 871-2204

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

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, 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": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1700115292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15101 PARRISH RD",
            "city": "UPPERCO",
            "state": "MD",
            "postal_code": "211559766",
            "telephone_number": "443-744-0126",
            "fax_number": "443-817-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 WILKENS AVE",
            "address_2": "STE 308",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295214",
            "telephone_number": "443-744-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARUSO",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-14",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.