Individual provider Active NPI

Susan Wasserman, MSW

  • Clinical Social Worker
  • Shorewood, WI
National Provider Identifier
1871652230
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
426-123 Issued in WI
Practice address
3970 N Oakland Ave
Shorewood, WI 53211-2265
Phone
(414) 332-9096
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 426-123 WI Primary

Addresses

Primary practice location

3970 N Oakland Ave
Shorewood, WI 53211-2265

Mailing address

2932 N Hackett Ave
Milwaukee, WI 53211-3442
Phone (414) 961-0649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20090423000487 WI Practitioner - Clinical Social Worker 3870641236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3970 N Oakland Ave
Suite 408
Milwaukee, WI 53211-2265
Phone (414) 961-0649

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
426-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Susan Wasserman LLC Clinical CurrentSince May 1, 2010 Accepting new patients

Locations

3970 N Oakland Ave
Ste 408
Shorewood, WI 53211
Phone (414) 961-0649

3970 N Oakland Ave
Ste 502
Shorewood, WI 53211
Phone (414) 332-9096

Organizations & group practices 1

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871652230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2932 N HACKETT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532113442",
            "telephone_number": "414-961-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 N OAKLAND AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112265",
            "telephone_number": "414-332-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "426-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shorewood, WI

Sources for this page

Verify at the official NPI Registry.