Individual provider Active NPI

Victoria Borsukevich

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1992186787
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I1700546 Issued in OH
Practice address
399 E Main St
Columbus, OH 43215-5384
Phone
(614) 355-8550
Fax
(614) 355-8593
NPI assigned
Jun 17, 2015
Last updated
Sep 13, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

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 I1700546 OH Primary

Addresses

Primary practice location

399 E Main St
Columbus, OH 43215-5384

Mailing address

Dept 781625
Detroit, MI 48278-1625
Phone (614) 355-8004

Other identifiers 1

IdentifierTypeStateIssuer
2846675MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240705001669 OH Practitioner - Clinical Social Worker 1153865845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbus Behavioral Health, LLCGroup PAC ID 4385081249, 16 clinicians

Practice addresses (Care Compare)

124 County Line Rd W
Suite B
Westerville, OH 43082-7233
Phone (614) 360-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I1700546OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Behavioral Health, LLC Clinical CurrentSince May 8, 2024 Accepting new patients
Nationwide Children's Hospital, Inc Past Accepting new patients

Locations

6265 Riverside Dr
Ste 1S
Dublin, OH 43017
Phone (614) 360-2600

115 Commerce Park Dr
Westerville, OH 43082
Phone (614) 360-2600

115 Commerce Park Dr
Ste B
Westerville, OH 43082
Phone (614) 360-2600

124 County Line Rd W
Ste B
Westerville, OH 43082
Phone (614) 360-2600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505260800000",
    "number": "1992186787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 781625",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781625",
            "telephone_number": "614-355-8004",
            "fax_number": "614-355-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155384",
            "telephone_number": "614-355-8550",
            "fax_number": "614-355-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORSUKEVICH",
        "first_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2017-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I1700546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.