Individual provider Active NPI

Jillian Nancy-Grace Bueno, LISW-S

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1740721729
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1700211-SUPV Issued in OH
Practice address
1730 W 25TH St
Cleveland, OH 44113
Phone
(216) 696-4030
NPI assigned
Mar 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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 I.1700211-SUPV OH Primary

Addresses

Primary practice location

1730 W 25TH St
Cleveland, OH 44113

Mailing address

20000 Lorain Rd
Apt 607
Fairview Park, OH 44126-3479
Phone (216) 402-3060

Other practice location 1

1744 Payne Ave
Cleveland, OH 44114-2910
Phone (216) 623-6888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20201231001644 OH Practitioner - Clinical Social Worker 7911310305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8530

Hospital & facility affiliations

  • Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230
  • Fairview Hospital Hospital, Cleveland, OH, CCN 360077
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Dec 16, 2020 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

1730 W 25th St
Cleveland, OH 44113
Phone (216) 696-4300

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1740721729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20000 LORAIN RD",
            "address_2": "APT 607",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263479",
            "telephone_number": "216-402-3060",
            "fax_number": "216-861-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 W 25TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44113",
            "telephone_number": "216-696-4030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1744 Payne Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441142910",
            "country_code": "US",
            "telephone_number": "216-623-6888",
            "fax_number": "216-861-7671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUENO",
        "first_name": "JILLIAN",
        "middle_name": "NANCY-GRACE",
        "name_prefix": "Mrs.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-10",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1700211-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.