Active NPI
Rosan Gomperts, LCSW
- Clinical Social Worker
- Stanford, CA
National Provider Identifier
1780912931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 20798
- Practice address
- 585 Capistrano Way
Mariposa House
Stanford, CA 94305-8550 - Phone
- (650) 723-4577
- NPI assigned
- Nov 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 20798 | CA | Primary |
Addresses
Primary practice location
585 Capistrano Way
Mariposa House
Stanford, CA 94305-8550
Mailing address
585 Capistrano Way
Mariposa House
Stanford, CA 94305-8550
Phone (650) 723-4577
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 1, 2024 through Mar 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20798 | CA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Trustees for Leland Stanford Junior University | Past | Accepting new patients |
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.
-
- Counselor
- Stanford, CA
- NPI 1235422189
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259539200000",
"number": "1780912931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "585 CAPISTRANO WAY",
"address_2": "MARIPOSA HOUSE",
"city": "STANFORD",
"state": "CA",
"postal_code": "943058550",
"telephone_number": "650-723-4577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "585 CAPISTRANO WAY",
"address_2": "MARIPOSA HOUSE",
"city": "STANFORD",
"state": "CA",
"postal_code": "943058550",
"telephone_number": "650-723-4577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMPERTS",
"first_name": "ROSAN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-30",
"last_updated": "2009-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "20798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.