JONATHAN A KALLIS (LCSW) – Clinical Social Worker, NPI 1629017868

JONATHAN A KALLIS (LCSW) is a healthcare provider. based in Mason, Ohio. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. I0009706 (OH). The NPI Number for JONATHAN A KALLIS (LCSW) is 1629017868

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
JONATHAN A KALLIS (LCSW)
NPI
1629017868
Phone
(513) 774-9444
Address
PO BOX 995
Enumeration Date
5 June 2006
Last Update Date
30 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7603403911
Graduation Year
1993 (33 years ago)
PAC ID
3577451442
Group Practice PAC ID
5890689657
Professional Enrollment ID
I20200403001217
Address ID
CA922703221RA39000DRXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience78
Completeness75
Years active:20State licenses:2Digital endpointsOther names

4,987 CLINICAL SOCIAL WORKER in CA

Provider Addresses for JONATHAN A KALLIS (LCSW)

  • PO BOX 995

    MASON, OH 45040

    Phone: (513) 774-9444

    Fax: (513) 774-9888

    Type: Mailing

  • 39000 BOB HOPE DR

    RANCHO MIRAGE, CA 922703221

    Phone: (760) 837-8767

    Fax: (760) 837-8806

    Type: Location

  • Ramsey Street, Banning, Riverside County, California, 92220, United States

    BANNING, CA 922203781

    Phone: (951) 849-6794

    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: 2020-04-03

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
I20200403001217IClinical Social WorkerCATBD

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
90837Psychotherapy, 1 hour59575$0
90791Psychiatric diagnostic evaluation3737$0
View full utilization report →

Insurance plans in this area (ZIP 45040)

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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: 5890689657View full group profile
NameSpecialtyState
Diagnostic RadiologyCA
A N E S T H E S I O L O G YCA
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)CA
-CA
Hematology/Oncology, Internal MedicineCA
-CA
Hematology/Oncology, Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
Family PracticeCA

Reviews

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Frequently asked questions

How is JONATHAN A KALLIS (LCSW) identified in CMS data?
CMS-hosted NPPES data lists JONATHAN A KALLIS (LCSW) with NPI 1629017868.
Does the file indicate JONATHAN A KALLIS (LCSW) is practicing under active NPI?
Directory data currently reports JONATHAN A KALLIS (LCSW) as active.
What is JONATHAN A KALLIS (LCSW)'s specialty?
The listing groups JONATHAN A KALLIS (LCSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where should I expect JONATHAN A KALLIS (LCSW) on a map?
Expect Mason, Ohio as a primary anchor for JONATHAN A KALLIS (LCSW) unless the record lists multiple sites.
Is the information about JONATHAN A KALLIS (LCSW) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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