Individual provider Active NPI

Jasmine Casanova, LCSW

  • Clinical Social Worker
  • Fort Hood, TX
National Provider Identifier
1750787107
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
58379 Issued in TX
Practice address
36000 Darnall Loop
Fort Hood, TX 76544-5095
Phone
(917) 775-1106
NPI assigned
Nov 12, 2014
Last updated
Jun 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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 58379 TX Primary

Addresses

Primary practice location

36000 Darnall Loop
Fort Hood, TX 76544-5095

Mailing address

2102 Ryan Dr
Copperas Cove, TX 76522-7708
Phone (917) 775-1106

Other identifiers 1

IdentifierTypeStateIssuer
58379OtherTXLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220622003428 TX Practitioner - Clinical Social Worker 7517346455 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
Group practices
Assurasource LTDGroup PAC ID 8123125580, 61 clinicians

Practice addresses (Care Compare)

400 N Allen Dr
Allen, TX 75013-2568
Phone (972) 233-1010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Assurasource LTD Clinical CurrentSince Jun 13, 2022 Accepting new patients

Locations

400 N Allen Dr
Ste 204
Allen, TX 75013

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": "1415750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1750787107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 RYAN DR",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765227708",
            "telephone_number": "917-775-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 DARNALL LOOP",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765445095",
            "telephone_number": "917-775-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASANOVA",
        "first_name": "JASMINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-12",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "58379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "58379",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Hood, TX

Sources for this page

Verify at the official NPI Registry.