JESSICA DOBBERTIN BORRUSO (LCSW) – Clinical Social Worker, NPI 1053787077

JESSICA DOBBERTIN BORRUSO (LCSW) is a healthcare provider. based in Bartow, Florida. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. SW15912 (FL). The NPI Number for JESSICA DOBBERTIN BORRUSO (LCSW) is 1053787077

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA DOBBERTIN BORRUSO (LCSW)
NPI
1053787077
Phone
(863) 519-0575
Address
1239 E Main St
Enumeration Date
13 August 2015
Last Update Date
3 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8635190575
Graduation Year
2016 (10 years ago)
PAC ID
7416282157
Group Practice PAC ID
7719877927
Professional Enrollment ID
I20190717001857
Address ID
FL338053017LA1835XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:10State licenses:1Digital endpointsOther names

3,374 CLINICAL SOCIAL WORKER in FL

Provider Addresses for JESSICA DOBBERTIN BORRUSO (LCSW)

  • 1239 E Main St

    Bartow, FL 338305058

    Phone: (863) 519-0575

    Fax: (863) 582-9251

    Type: Location

  • PO BOX 1559

    BARTOW, FL 338311559

    Phone: (863) 519-0575

    Fax: (863) 582-9251

    Type: Mailing

  • 1835 GILMORE AVE

    LAKELAND, FL 338053017

    Phone: (863) 519-0575

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-07-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190717001857IClinical Social WorkerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes7212$0
View full utilization report →

Insurance plans in this area (ZIP 33830)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7719877927View full group profile
NameSpecialtyState
P S Y C H I A T R YFL
Clinical Social WorkerFL
P S Y C H I A T R YFL
Mental Health CounselorFL
Clinical Social WorkerFL
-FL
Marriage And Family TherapistFL
Clinical Social WorkerFL
-FL
Mental Health CounselorFL

Reviews

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Frequently asked questions

How do I look up JESSICA DOBBERTIN BORRUSO (LCSW) by NPI?
Use NPI 1053787077 when you need to reference JESSICA DOBBERTIN BORRUSO (LCSW) in forms, claims, or directories.
Is JESSICA DOBBERTIN BORRUSO (LCSW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is JESSICA DOBBERTIN BORRUSO (LCSW)?
The page reflects Clinical Social Worker for JESSICA DOBBERTIN BORRUSO (LCSW). Clinical services aligned with this taxonomy classification.
Where is JESSICA DOBBERTIN BORRUSO (LCSW)'s primary listing?
We display Bartow, Florida because that is what the record indicates for JESSICA DOBBERTIN BORRUSO (LCSW).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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