Individual provider Active NPI

James Mayer, LCSW-R

  • Social Worker
  • Glen Head, NY
National Provider Identifier
1003118027
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
073722-1 Issued in NY
Practice address
333 Glen Head Rd
Suite 155
Glen Head, NY 11545-1947
Phone
(516) 521-1254
Fax
(631) 651-5589
NPI assigned
Nov 23, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 073722-1 NY Primary
Clinical Social Worker 1041C0700X 079090 NY

Addresses

Primary practice location

333 Glen Head Rd
Suite 155
Glen Head, NY 11545-1947

Mailing address

333 Glen Head Rd
Suite 155
Glen Head, NY 11545-1947
Phone (516) 521-1254

Other identifiers 1

IdentifierTypeStateIssuer
03003069MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120803000012 NY Practitioner - Clinical Social Worker 1557517752 Practice locations: Glen Head, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073722-1NYMDSocial Worker

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1003118027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 GLEN HEAD RD",
            "address_2": "SUITE 155",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451947",
            "telephone_number": "516-521-1254",
            "fax_number": "631-651-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 GLEN HEAD RD",
            "address_2": "SUITE 155",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451947",
            "telephone_number": "516-521-1254",
            "fax_number": "631-651-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-23",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "073722-1",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079090",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03003069",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Head, NY

Sources for this page

Verify at the official NPI Registry.