Individual provider Active NPI

Rebecca Cecilia Moreno

  • Social Worker
  • Colorado Springs, CO
National Provider Identifier
1942853049
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
CSW.09926092 Issued in CO
Practice address
220 Ruskin Dr
Colorado Springs, CO 80910-2522
Phone
(719) 572-6100
NPI assigned
Jul 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CSW.09926092 CO Primary

Addresses

Primary practice location

220 Ruskin Dr
Colorado Springs, CO 80910-2522

Mailing address

220 Ruskin Dr
Colorado Springs, CO 80910-2522
Phone (719) 572-6100

Other practice location 1

1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (124) 356-9659

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190816000580 CO Practitioner - Clinical Social Worker 4082941836 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Oct 31, 2022 Accepting new patients
Family Care Center, LLC CurrentSince Feb 1, 2023 Accepting new patients
Family Care Center, LLC CurrentSince Feb 1, 2023 Accepting new patients
Diversus Health Inc CurrentSince May 22, 2023 Accepting new patients

Locations

460 County Road 43
Ste 7
Bailey, CO 80421
Phone (303) 838-5013

328 10th St
Calhan, CO 80808

413 Security Blvd
Colorado Springs, CO 80911

115 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6340

220 Ruskin Dr
Colorado Springs, CO 80910
Phone (719) 572-6150

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

6208 Lehman Dr
Colorado Springs, CO 80918
Phone (719) 572-6133

1795 Jet Wing Dr
Colorado Springs, CO 80916
Phone (719) 572-6111

179 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6300

875 W Moreno Ave
Colorado Springs, CO 80905
Phone (719) 572-6200

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

18401 Highway 24
Ste 119
Woodland Park, CO 80863

Organizations & group practices 4

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": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1942853049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RUSKIN DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809102522",
            "telephone_number": "719-572-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 RUSKIN DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809102522",
            "telephone_number": "719-572-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1061 Harmon Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Stewart",
            "state": "GA",
            "postal_code": "313145641",
            "country_code": "US",
            "telephone_number": "124-356-9659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "REBECCA",
        "middle_name": "CECILIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "CSW.09926092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.