Individual provider Active NPI

Ryan Matthew Sheade, LCSW

  • Clinical Social Worker
  • Scottsdale, AZ
National Provider Identifier
1780918839
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-13100 Issued in AZ
Practice address
8079 N 85TH Way
Scottsdale, AZ 85258-4321
Phone
(480) 261-5015
Fax
(602) 368-8266
NPI assigned
Sep 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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 LCSW-13100 AZ Primary

Addresses

Primary practice location

8079 N 85TH Way
Scottsdale, AZ 85258-4321

Mailing address

8079 N 85TH Way
Scottsdale, AZ 85258-4321
Phone (480) 261-5015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20111020000048 AZ Practitioner - Clinical Social Worker 6002088820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ryan M Sheade LCSW LLCGroup PAC ID 3971813536, 2 clinicians

Practice addresses (Care Compare)

8079 N 85TH Way
Scottsdale, AZ 85258-4321
Phone (480) 261-5015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-13100AZMDClinical Social Worker

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.

NPI Registry JSON

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1780918839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8079 N 85TH WAY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584321",
            "telephone_number": "480-261-5015",
            "fax_number": "602-368-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8079 N 85TH WAY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584321",
            "telephone_number": "480-261-5015",
            "fax_number": "602-368-8266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEADE",
        "first_name": "RYAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-22",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-13100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.