Active NPI
Richard Sasicki, LCSW
- Clinical Social Worker
- Pueblo, CO
National Provider Identifier
1851586291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 503 N Main St Ste 324
Pueblo, CO 81003-3139 - Phone
- (719) 506-9241
- Fax
- (855) 775-0361
- NPI assigned
- Sep 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
503 N Main St Ste 324
Pueblo, CO 81003-3139
Mailing address
PO Box 9264
Pueblo, CO 81008-9264
Phone (719) 506-9241
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851586291 | Other | CO | NPT |
| 895006 | Medicaid | CO | |
| 9000137255 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040818001269 | CO | Practitioner - Clinical Social Worker | 3779556527 | Practice locations: Pueblo, CO |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
503 N Main St
Pueblo, CO 81003-3139
Phone (719) 506-9241
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717718400000",
"number": "1851586291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9264",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810089264",
"telephone_number": "719-506-9241",
"fax_number": "855-775-0361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 N MAIN ST STE 324",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810033139",
"telephone_number": "719-506-9241",
"fax_number": "855-775-0361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SASICKI",
"first_name": "RICHARD",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-10",
"last_updated": "2024-06-07",
"certification_date": "2024-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPT",
"identifier": "1851586291",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "895006",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000137255",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.