Individual provider Active NPI

Debra Marcus Doodkevitch, LCSW, ACSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1801027586
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5682-C Issued in NV
Practice address
5600 Spring Mountain Rd
Ste 207
Las Vegas, NV 89146-8823
Phone
(702) 228-8236
Fax
(702) 442-7190
NPI assigned
Jul 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5682-C NV Primary
Other Technician 247200000X CNTH#200510 NY
Social Worker 104100000X 5557-N NV
Clinical Social Worker 1041C0700X LCS8748 CA

Addresses

Primary practice location

5600 Spring Mountain Rd
Ste 207
Las Vegas, NV 89146-8823

Mailing address

5530 Kings Row CT
Las Vegas, NV 89148-4658
Phone (702) 219-5046

Other names 1

  • Debra Marcus Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20100115000617 NV Practitioner - Clinical Social Worker 4082756960 Reassigns benefits to 1 organization
Practice locations: Las Vegas, NV

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5600 Spring Mountain Rd
Suite 207
Las Vegas, NV 89146-8823
Phone (702) 228-8236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5557-NNVMDSocial Worker
LCS8748CAMDClinical Social Worker
5682-CNVMDClinical Social Worker
CNTH#200510NYMDOther Technician

Practice roles

OrganizationSpecialtyStatusNew patients
BMSC NV LLC Clinical CurrentSince Feb 7, 2022 Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. Past Accepting new patients
Debra M Doodkevitch Clinical Past Accepting new patients

Locations

10204 Bode St
Ste B
Plainfield, IL 60585
Phone (630) 229-6462

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": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1801027586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 KINGS ROW CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484658",
            "telephone_number": "702-219-5046",
            "fax_number": "702-442-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 SPRING MOUNTAIN RD",
            "address_2": "STE 207",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891468823",
            "telephone_number": "702-228-8236",
            "fax_number": "702-442-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOODKEVITCH",
        "first_name": "DEBRA",
        "middle_name": "MARCUS",
        "credential": "LCSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-29",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "5682-C",
            "primary": true
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "NY",
            "license": "CNTH#200510",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NV",
            "license": "5557-N",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS8748",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "MARCUS",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.