Individual provider Active NPI

Brian Anerino

  • Clinical Social Worker
  • Downers Grove, IL
National Provider Identifier
1962946111
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
251SOOOOOX Issued in IL
Practice address
4923 Main St
Downers Grove, IL 60515-3654
Phone
(630) 206-0272
Fax
(630) 589-9123
NPI assigned
Dec 7, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.017150 IL
Clinical Social Worker 1041C0700X 46-5304932 IL
Clinical Social Worker 1041C0700X 251SOOOOOX IL Primary

Addresses

Primary practice location

4923 Main St
Downers Grove, IL 60515-3654

Mailing address

2214 Country Club Dr Apt 4
Woodridge, IL 60517-3006

Other identifiers 1

IdentifierTypeStateIssuer
1942610738MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20230913001026 IL Practitioner - Clinical Social Worker 9830553668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mosaic Counseling and Wellness LLCGroup PAC ID 1355728353, 29 clinicians

Practice addresses (Care Compare)

386 N York St
Elmhurst, IL 60126-2363
Phone (312) 213-7862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.017150ILMDClinical Social Worker
251SOOOOOXILMDClinical Social Worker
46-5304932ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Counseling and Wellness LLC CurrentSince Aug 21, 2023 Accepting new patients

Locations

386 N York St
Elmhurst, IL 60126
Phone (312) 213-7862

119 E Ogden Ave
Ste 130
Hinsdale, IL 60521
Phone (708) 628-8000

215 Harrison St
Oak Park, IL 60304
Phone (708) 628-8000

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": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1962946111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 COUNTRY CLUB DR APT 4",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605173006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4923 MAIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153654",
            "telephone_number": "630-206-0272",
            "fax_number": "630-589-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANERINO",
        "first_name": "BRIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017150",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "46-5304932",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "251SOOOOOX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942610738",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.