Individual provider Active NPI

Jessica L. Bosarge, LCSW

  • Clinical Social Worker
  • Batavia, NY
National Provider Identifier
1740513969
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
080880-01 Issued in NY
Practice address
5130 E Main St Ste 2
Batavia, NY 14020-3444
Phone
(585) 344-1421
Fax
(585) 344-3047
NPI assigned
Sep 8, 2009
Last updated
Sep 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 080880-01 NY
Clinical Social Worker 1041C0700X 080880-01 NY Primary

Addresses

Primary practice location

5130 E Main St Ste 2
Batavia, NY 14020-3444

Mailing address

3020 Bailey Ave
Buffalo, NY 14215-2814
Phone (716) 831-0200

Other practice location 1

3020 Bailey Ave
Buffalo, NY 14215-2814
Phone (716) 831-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140129001306 NY Practitioner - Clinical Social Worker 8224267968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of Genesee County TreasurerGroup PAC ID 2961398060, 14 clinicians

Practice addresses (Care Compare)

5130 E Main St Rd
Suite 2
Batavia, NY 14020-3496
Phone 58534414216610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
080880-01NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Genesee County Treasurer CurrentSince Jan 19, 2022 Accepting new patients
County of Genesee County Treasurer CurrentSince Jan 19, 2022 Accepting new patients

Locations

5130 E Main Street Rd
Ste 2
Batavia, NY 14020
Phone (585) 344-1421

Organizations & group practices 2

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": "1252368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1740513969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142152814",
            "telephone_number": "716-831-0200",
            "fax_number": "716-831-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 E MAIN ST STE 2",
            "city": "BATAVIA",
            "state": "NY",
            "postal_code": "140203444",
            "telephone_number": "585-344-1421",
            "fax_number": "585-344-3047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3020 Bailey Ave",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142152814",
            "country_code": "US",
            "telephone_number": "716-831-0200",
            "fax_number": "716-831-0206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSARGE",
        "first_name": "JESSICA",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-08",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "080880-01",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080880-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, NY

Sources for this page

Verify at the official NPI Registry.