Individual provider Active NPI

Mary I. Bazie, MSSA

  • Social Worker
  • Cleveland, OH
National Provider Identifier
1821374406
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.0700319-SUPV Issued in OH
Practice address
Care Alliance Health Center
2916 Central Ave
Cleveland, OH 44115-3229
Phone
(216) 535-9100
Fax
(216) 535-2626
NPI assigned
Oct 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.0700319 OH
Social Worker 104100000X
Social Worker 104100000X I.0700319-SUPV OH Primary

Addresses

Primary practice location

Care Alliance Health Center
2916 Central Ave
Cleveland, OH 44115-3229

Mailing address

Care Alliance Health Center
2916 Central Ave
Cleveland, OH 44115-3229
Phone (216) 535-9100

Other identifiers 1

IdentifierTypeStateIssuer
0217599MedicaidOH

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
I20240206003918 OH Practitioner - Clinical Social Worker 7911337670 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICDC.0700319OHMDAddiction (Substance Use Disorder) Counselor
I.0700319-SUPVOHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Care Alliance CurrentSince Feb 7, 2024 Accepting new patients
Care Alliance CurrentSince Feb 7, 2024 Accepting new patients
Care Alliance Current Accepting new patients

Locations

1530 Saint Clair Ave NE
Cleveland, OH 44114
Phone (216) 535-9100

6001 Woodland Ave
Cleveland, OH 44104
Phone (216) 431-2018

2916 Central Ave
Cleveland, OH 44115
Phone (216) 535-9100

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": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1821374406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CARE ALLIANCE HEALTH CENTER",
            "address_2": "2916 CENTRAL AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153229",
            "telephone_number": "216-535-9100",
            "fax_number": "216-535-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARE ALLIANCE HEALTH CENTER",
            "address_2": "2916 CENTRAL AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153229",
            "telephone_number": "216-535-9100",
            "fax_number": "216-535-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZIE",
        "first_name": "MARY",
        "middle_name": "I.",
        "credential": "MSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-27",
        "last_updated": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.0700319",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.0700319-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0217599",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.