Individual provider Active NPI

Gail S Bach, PHD, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1023170586
Registry record updated Oct 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR020388-1 Issued in NY
Practice address
209 W 80TH St Apt 1C
New York, NY 10024-7050
Phone
(212) 874-2857
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2009

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 PR020388-1 NY Primary

Addresses

Primary practice location

209 W 80TH St Apt 1C
New York, NY 10024-7050

Mailing address

209 W 80TH St Apt 1C
New York, NY 10024-7050
Phone (212) 874-2857

Other identifiers 1

IdentifierTypeStateIssuer
PR020388-1OtherNYLICENSE NUMBER NEW YORK S

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
I20091026000637 NY Practitioner - Clinical Social Worker 6305983206 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

209 W 80TH St
New York, NY 10024-7049
Phone (646) 483-2575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PR020388-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254873600000",
    "number": "1023170586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W 80TH ST APT 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100247050",
            "telephone_number": "212-874-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W 80TH ST APT 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100247050",
            "telephone_number": "212-874-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACH",
        "first_name": "GAIL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2009-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR020388-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER NEW YORK S",
            "identifier": "PR020388-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.