Individual provider Active NPI

Roberta I Vena, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1881957280
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW017332 Issued in PA
Practice address
4200 Monument Rd
Philadelphia, PA 19131-1625
Phone
(215) 581-3826
Fax
(215) 581-3892
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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 CW017332 PA Primary

Addresses

Primary practice location

4200 Monument Rd
Philadelphia, PA 19131-1625

Mailing address

1012 S 6TH St
Philadelphia, PA 19147-4012
Phone (267) 283-7583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20121121000319 PA Practitioner - Clinical Social Worker 3870744816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of PhiladelphiaGroup PAC ID 6305758723, 86 clinicians

Practice addresses (Care Compare)

321 W Girard Ave
Health Care Ctr 6
Philadelphia, PA 19123-1531
Phone (215) 685-3808

4400 Haverford Ave
Philadelphia, PA 19104-1361
Phone (215) 685-7630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Management Corporation Current Accepting new patients
City of Philadelphia CurrentSince May 13, 2019 Accepting new patients
City of Philadelphia Current Accepting new patients
City of Philadelphia CurrentSince May 13, 2019 Accepting new patients
Public Health Management Corporation CurrentSince May 12, 2017 Accepting new patients
Jefferson University Physicians Past Accepting new patients
Mazzoni Center PastSince Jan 1, 2007 Accepting new patients

Locations

5675 N Front St
Philadelphia, PA 19120
Phone (215) 224-0440

1900 N 9th St
Ste 104
Philadelphia, PA 19122
Phone (215) 735-6690

1101 Market St
Fl 10
Philadelphia, PA 19107

125 S 9th St
Philadelphia, PA 19107
Phone (215) 592-4500

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

Interoperability endpoints

  • Direct secure messaging: robertavena@nncc.allscriptsdirect.net

Organizations & group practices 7

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1881957280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 S 6TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191474012",
            "telephone_number": "267-283-7583",
            "fax_number": "215-581-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 MONUMENT RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311625",
            "telephone_number": "215-581-3826",
            "fax_number": "215-581-3892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENA",
        "first_name": "ROBERTA",
        "middle_name": "I",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.