Individual provider Active NPI

Eline Atis

  • Clinical Social Worker
  • Jersey City, NJ
National Provider Identifier
1033940507
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SL065500100 Issued in NJ
Practice address
613 Washington Blvd
Jersey City, NJ 07310-2900
Phone
(862) 444-5213
NPI assigned
Aug 8, 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
Clinical Social Worker 1041C0700X 44SL065500100 NJ Primary

Addresses

Primary practice location

613 Washington Blvd
Jersey City, NJ 07310-2900

Mailing address

PO Box 771073
Orlando, FL 32877-1073

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
44SL065500100NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1033940507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 771073",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328771073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 WASHINGTON BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073102900",
            "telephone_number": "862-444-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATIS",
        "first_name": "ELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL065500100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

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.