Individual provider Active NPI

Jonathan Goldwasser, LMSW

  • Clinical Social Worker
  • Peekskill, NY
National Provider Identifier
1043684590
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
097105 Issued in NY
Practice address
114 Riverbend Dr
Peekskill, NY 10566-4461
Phone
(914) 356-2995
NPI assigned
Nov 20, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 096095 NY
Clinical Social Worker 1041C0700X 097105 NY Primary

Addresses

Primary practice location

114 Riverbend Dr
Peekskill, NY 10566-4461

Mailing address

114 Riverbend Dr
Peekskill, NY 10566-4461
Phone (914) 356-2995

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
I20240402002385 NY Practitioner - Clinical Social Worker 7214375849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Young Adult Institute IncGroup PAC ID 1153216353, 28 clinicians

Practice addresses (Care Compare)

227 E 41St St
FL 8
New York, NY 10017-6927
Phone (212) 273-6521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
096095NYMDSocial Worker
097105NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Healthcare, Inc. CurrentSince May 1, 2025 Accepting new patients
Young Adult Institute, Inc. CurrentSince Feb 22, 2024 Accepting new patients
Premier Healthcare, Inc. CurrentSince May 1, 2025 Accepting new patients

Locations

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

21111 Northern Blvd
#13292
Bayside, NY 11361
Phone (718) 705-1000

3060 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1790

3060 E Tremont Ave
#2
Bronx, NY 10461

175 Remsen St
Fl 4
Brooklyn, NY 11201
Phone (212) 273-6182

220 E 42nd St
Fl 8
New York, NY 10017
Phone (212) 273-2761

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

227 E 41St St
New York, NY 10017

Interoperability endpoints

  • Direct secure messaging: jonathan.goldwasser.p1@direct.premierhealthcare.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1043684590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 RIVERBEND DR",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105664461",
            "telephone_number": "914-356-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 RIVERBEND DR",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105664461",
            "telephone_number": "914-356-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDWASSER",
        "first_name": "JONATHAN",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-20",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "096095",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peekskill, NY

Sources for this page

Verify at the official NPI Registry.