Individual provider Active NPI

Damaris Moreno

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1851011886
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149023207 Issued in IL
Practice address
1969 W Ogden Ave
Chicago, IL 60612-3765
Phone
(312) 864-0200
NPI assigned
Aug 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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 149023207 IL Primary

Addresses

Primary practice location

1969 W Ogden Ave
Chicago, IL 60612-3765

Mailing address

1969 W Ogden Ave
Chicago, IL 60612-3765
Phone (312) 864-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20221017001798 IL Practitioner - Clinical Social Worker 6002282027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149023207ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Sep 23, 2022 Accepting new patients
Cook County CurrentSince Sep 23, 2022 Accepting new patients
Cook County Current Accepting new patients

Locations

1900 W Polk St
Ste 220C
Chicago, IL 60612

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

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": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1851011886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1969 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123765",
            "telephone_number": "312-864-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123765",
            "telephone_number": "312-864-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "DAMARIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149023207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.