Individual provider Active NPI

Aldrin Osvaldo Ceballos, LCSW-C

  • Clinical Social Worker
  • Gaithersburg, MD
National Provider Identifier
1811275423
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14168 Issued in MD
Practice address
604 S Frederick Ave
Ste 215
Gaithersburg, MD 20877-1282
Phone
(202) 390-4487
Fax
(301) 740-2192
NPI assigned
Jul 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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 14168 MD Primary

Addresses

Primary practice location

604 S Frederick Ave
Ste 215
Gaithersburg, MD 20877-1282

Mailing address

20332 Cedarhurst Way
Germantown, MD 20876-5642
Phone (202) 390-4487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20111019000457 DC Practitioner - Clinical Social Worker 6901078880 Reassigns benefits to 3 organizations
Practice locations: Gaithersburg, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cornerstone Montgomery IncGroup PAC ID 3971591751, 23 clinicians
LCH Behavioral Health IncGroup PAC ID 3072056472, 2 clinicians

Practice addresses (Care Compare)

1398 Lamberton Dr
Silver Spring, MD 20902-3414
Phone (301) 493-4200

6040 Southport Dr
Bethesda, MD 20814-1848
Phone (301) 493-4200

9055 Shady Grove CT
Gaithersburg, MD 20877-1301
Phone (301) 944-2746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14168MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Montgomery, Inc. CurrentSince Mar 8, 2012 Accepting new patients
Cornerstone Montgomery, Inc. CurrentSince Mar 8, 2012 Accepting new patients
Cornerstone Montgomery, Inc. Current Accepting new patients
Adventist Physician Services, Inc. CurrentSince Oct 1, 2015 Accepting new patients

Locations

6040 Southport Dr
Bethesda, MD 20814
Phone 3014934200228

820 W Diamond Ave
Ste 500
Gaithersburg, MD 20878

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

2 Taft Ct
Ste 200
Rockville, MD 20850
Phone (301) 715-3673

Interoperability endpoints

  • Direct secure messaging: aldrin.ceballos.p1@direct.mcg-hhs.nextgenshare.com

Organizations & group practices 5

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": "1312070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521417600000",
    "number": "1811275423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20332 CEDARHURST WAY",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208765642",
            "telephone_number": "202-390-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S FREDERICK AVE",
            "address_2": "STE 215",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771282",
            "telephone_number": "202-390-4487",
            "fax_number": "301-740-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEBALLOS",
        "first_name": "ALDRIN",
        "middle_name": "OSVALDO",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-31",
        "last_updated": "2018-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.