Individual provider Active NPI

Thomas W. Shupe

  • Social Worker
  • Cleveland, OH
National Provider Identifier
1801254420
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S 1302928 Issued in OH
Practice address
4400 Euclid Ave
Cleveland, OH 44103-3734
Phone
(216) 432-7200
Fax
(216) 432-7253
NPI assigned
Feb 10, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S 1302928 OH Primary

Addresses

Primary practice location

4400 Euclid Ave
Cleveland, OH 44103-3734

Mailing address

4500 Euclid Ave
Cleveland, OH 44103-3736
Phone (216) 432-7200

Other identifiers 1

IdentifierTypeStateIssuer
S 1302928OtherSTATE LICENSE

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
I20241106003489 OH Practitioner - Clinical Social Worker 4981138419 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S 1302928OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Circle Health Services CurrentSince Aug 10, 2024 Accepting new patients
Circle Health Services CurrentSince Aug 10, 2024 Accepting new patients
Circle Health Services Past Accepting new patients

Locations

4500 Euclid Ave
Cleveland, OH 44103
Phone (216) 325-9404

4400 Euclid Ave
Cleveland, OH 44103
Phone (216) 325-9355

12201 Euclid Ave
Cleveland, OH 44106
Phone (216) 373-2846

3929 Rocky River Dr
Cleveland, OH 44111
Phone (216) 252-5800

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": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1801254420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441033736",
            "telephone_number": "216-432-7200",
            "fax_number": "216-432-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441033734",
            "telephone_number": "216-432-7200",
            "fax_number": "216-432-7253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUPE",
        "first_name": "THOMAS",
        "middle_name": "W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-10",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S 1302928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "S 1302928",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.