Active NPI
Jessica Hefele, MSW
- Early Intervention Provider Agency
- Brooklyn, NY
National Provider Identifier
1013455229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- Practice address
- 176 Clarkson Ave Apt 1a
Brooklyn, NY 11226-2028 - Phone
- (347) 512-9838
- NPI assigned
- Feb 8, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | NY | Primary | |
| Prevention Professional | 405300000X | NY |
Addresses
Primary practice location
176 Clarkson Ave Apt 1a
Brooklyn, NY 11226-2028
Mailing address
176 Clarkson Ave
1A
Brooklyn, NY 11226-2081
Phone (347) 512-9838
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 099637 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Interborough Developmental and Consultation Center, Inc. | Current | Accepting new patients | |
| Interborough Developmental and Consultation Center, Inc. | Current | Accepting new patients |
Locations
1623 Kings Hwy
Brooklyn, NY 11229
Phone (718) 307-6800
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Case Management Agency
- Brooklyn, NY
- NPI 1588611842
-
- Multi-Specialty Clinic/Center
- Brooklyn, NY
- NPI 1912867433
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1013455229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "176 CLARKSON AVE",
"address_2": "1A",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112262081",
"telephone_number": "347-512-9838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "176 CLARKSON AVE APT 1A",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112262028",
"telephone_number": "347-512-9838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEFELE",
"first_name": "JESSICA",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-08",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": "NY",
"license": null,
"primary": true
},
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "NY",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.