Individual provider Active NPI

Theresa A. Zugo, LCSW-R, CASAC

  • Clinical Social Worker
  • Rochester, NY
National Provider Identifier
1790951283
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R054253-1 Issued in NY
Practice address
490 East Ridge Road
Rochester, NY 14621-3001
Phone
(585) 922-4181
NPI assigned
May 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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 R054253-1 NY Primary

Addresses

Primary practice location

490 East Ridge Road
Rochester, NY 14621-3001

Mailing address

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4181

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
I20251006002676 OH Practitioner - Clinical Social Worker 2466624200 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Madison Ave
MSC S38805
Toledo, OH 43604-1516

1601 Brigham Dr
Suite 150
Perrysburg, OH 43551-7114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R054253-1NYMDClinical Social Worker
054253NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Aug 1, 2025 Accepting new patients
Memorial Professional Services LTD CurrentSince Aug 1, 2025 Accepting new patients
Promedica Central Physicians CurrentSince Aug 1, 2025 Accepting new patients

Locations

715 S Taft Ave
Fremont, OH 43420
Phone (419) 332-7321

1601 Brigham Dr
Ste 200
Perrysburg, OH 43551
Phone (419) 872-7700

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Organizations & group practices 3

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": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1790951283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 EAST RIDGE ROAD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUGO",
        "first_name": "THERESA",
        "middle_name": "A.",
        "credential": "LCSW-R, CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-05",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R054253-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.