Individual provider Active NPI

Shana K Peyser, MSW

  • Clinical Social Worker
  • Oregon City, OR
National Provider Identifier
1801117775
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L4438 Issued in OR
Practice address
998 Library CT
Oregon City, OR 97045-4041
Phone
(503) 655-8401
Fax
(503) 655-8429
NPI assigned
Jun 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X L4438 OR Primary

Addresses

Primary practice location

998 Library CT
Oregon City, OR 97045-4041

Mailing address

2051 Kaen Rd
Suite 367
Oregon City, OR 97045-4035
Phone (503) 742-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20150416000068 OR Practitioner - Clinical Social Worker 0648598078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

150 Beavercreek Rd
Oregon City, OR 97045-4302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clackamas County Current Accepting new patients
County of Clackamas Office of County Auditor CurrentSince Mar 9, 2015 Accepting new patients

Locations

2051 Kaen Rd
Ste 367
Oregon City, OR 97045
Phone (503) 742-5300

998 Courthouse Rd
Oregon City, OR 97045
Phone (503) 655-8470

39740 Pleasant St
Sandy, OR 97055
Phone (503) 563-7679

Organizations & group practices 2

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": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1801117775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 KAEN RD",
            "address_2": "SUITE 367",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454035",
            "telephone_number": "503-742-5300",
            "fax_number": "503-742-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 LIBRARY CT",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454041",
            "telephone_number": "503-655-8401",
            "fax_number": "503-655-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEYSER",
        "first_name": "SHANA",
        "middle_name": "K",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

Verify at the official NPI Registry.