Individual provider Active NPI

Maria Nerat

  • Clinical Social Worker
  • Menominee, MI
National Provider Identifier
1902143928
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801094525 Issued in MI
Practice address
401 10TH Ave
Menominee, MI 49858-3009
Phone
(906) 774-0522
NPI assigned
Jan 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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 6801094525 MI Primary

Addresses

Primary practice location

401 10TH Ave
Menominee, MI 49858-3009

Mailing address

715 Pyle Dr
Kingsford, MI 49802-4456

Other names 1

  • Maria Domitrovich Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150914001926 MI Practitioner - Clinical Social Worker 5496062143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 10TH Ave
Menominee, MI 49858-3009
Phone (906) 265-5126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801094525MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northpointe Behavioral Healthcare System CurrentSince Aug 2, 2015 Accepting new patients
Northpointe Behavioral Healthcare System Clinical CurrentSince Aug 2, 2015 Accepting new patients

Locations

715 Pyle Dr
Kingsford, MI 49802
Phone (906) 774-0522

401 10th Ave
Menominee, MI 49858
Phone (906) 774-0522

Organizations & group practices 2

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": "1357776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1902143928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 PYLE DR",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498024456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 10TH AVE",
            "city": "MENOMINEE",
            "state": "MI",
            "postal_code": "498583009",
            "telephone_number": "906-774-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERAT",
        "first_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-10",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "DOMITROVICH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Menominee, MI

Sources for this page

Verify at the official NPI Registry.