Individual provider Active NPI

Miranda Rydel, LMSW

  • Social Worker
  • Bronx, NY
National Provider Identifier
1013738004
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
124764 Issued in NY
Practice address
130 W Tremont Ave
Bronx, NY 10453-5436
Phone
(718) 583-9000
NPI assigned
Oct 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 124764 NY Primary

Addresses

Primary practice location

130 W Tremont Ave
Bronx, NY 10453-5436

Mailing address

130 W Tremont Ave
Bronx, NY 10453-5436
Phone (224) 203-0406

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
124764NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1013738004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104535436",
            "telephone_number": "224-203-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104535436",
            "telephone_number": "718-583-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDEL",
        "first_name": "MIRANDA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "124764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.