RON VANAUSDAL (LCSW) – Clinical Social Worker, NPI 1275956880

RON VANAUSDAL (LCSW) is a healthcare provider. based in Fruitland, Idaho. specializing in Clinical Social Worker. They hold the professional credentials LCSW. They hold a License No. LCSW-35711 (ID). The NPI Number for RON VANAUSDAL (LCSW) is 1275956880

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
RON VANAUSDAL (LCSW)
NPI
1275956880
Phone
(208) 291-1020
Address
1611 N WHITLEY DR
Enumeration Date
3 February 2014
Last Update Date
28 December 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2085463046
Graduation Year
2013 (13 years ago)
PAC ID
0446559710
Group Practice PAC ID
4183696214
Professional Enrollment ID
I20160509001720
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:12State licenses:2Digital endpointsOther names

Provider Addresses for RON VANAUSDAL (LCSW)

  • 1611 N WHITLEY DR

    FRUITLAND, ID 836192177

    Phone: (208) 291-1020

    Type: Location

  • 16204 BECKLEY CT

    NAMPA, ID 836878340

    Phone: (208) 602-1364

    Type: Mailing

  • 702 SUNSET DR

    ONTARIO, OR 979143121

    Phone: (541) 889-9167

    Fax: (541) 889-7873

    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: 2016-08-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20160509001720IClinical Social WorkerIDTBD
I20160819001997IClinical Social WorkerORTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83619)

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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: 4183696214View full group profile
NameSpecialtyState
Clinical Social WorkerOR
Mental Health CounselorOR
-ID
Clinical Social WorkerOR
Undefined Non Physician Type (Specify)OR
Clinical Social WorkerOR
-ID
-OH
Clinical Social WorkerOR
Undefined Non Physician Type (Specify)OR

Reviews

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Frequently asked questions

Can I use this page to confirm RON VANAUSDAL (LCSW)'s NPI?
Yes. RON VANAUSDAL (LCSW) is listed with NPI 1275956880 in the public NPI dataset.
Is RON VANAUSDAL (LCSW) still practicing?
RON VANAUSDAL (LCSW) is currently listed as active in the public NPI registry.
What is RON VANAUSDAL (LCSW)'s specialty?
The listing groups RON VANAUSDAL (LCSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does RON VANAUSDAL (LCSW) list a practice location?
Patients near Fruitland, Idaho may find RON VANAUSDAL (LCSW) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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