Individual provider Active NPI

Elina Malamud, LCSW

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1013163716
Registry record updated Mar 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076320-01 Issued in NY
Practice address
65 Weed Ave
Staten Island, NY 10306-4922
Phone
(917) 992-1647
NPI assigned
Aug 13, 2008
Last updated
Mar 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2010

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 076320-01 NY Primary

Addresses

Primary practice location

65 Weed Ave
Staten Island, NY 10306-4922

Mailing address

65 Weed Ave
Staten Island, NY 10306-4922
Phone (917) 992-1647

Other identifiers 1

IdentifierTypeStateIssuer
03084562MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
076320-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Elina Malamud LCSW LLC Current Accepting new patients
Shine Medical of Ca PC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1013163716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 WEED AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103064922",
            "telephone_number": "917-992-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 WEED AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103064922",
            "telephone_number": "917-992-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAMUD",
        "first_name": "ELINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076320-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03084562",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.