Individual provider Active NPI

Mitchell Craig Borgida, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1013088210
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R034410 Issued in NY
Practice address
154 E 71St St
Suite 1B
New York, NY 10021-5125
Phone
(212) 879-0357
Fax
(212) 879-0357
NPI assigned
Nov 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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 R034410 NY Primary

Addresses

Primary practice location

154 E 71St St
Suite 1B
New York, NY 10021-5125

Mailing address

177 E 87TH St Ste 201a
New York, NY 10128-2226
Phone (212) 879-0357

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
I20050405000059 NY Practitioner - Clinical Social Worker 8022065846 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

154 E 71St St
Apt 1B
New York, NY 10021-5123
Phone (212) 879-0357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R034410NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1013088210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 E 87TH ST STE 201A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101282226",
            "telephone_number": "212-879-0357",
            "fax_number": "212-879-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 E 71ST ST",
            "address_2": "SUITE 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215125",
            "telephone_number": "212-879-0357",
            "fax_number": "212-879-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGIDA",
        "first_name": "MITCHELL",
        "middle_name": "CRAIG",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R034410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.