Individual provider Active NPI

Jay Weintraub, LCSW

  • Clinical Social Worker
  • Bridgewater, NJ
National Provider Identifier
1053484642
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC04524000 Issued in NJ
Practice address
500 N Bridge St
Bridgewater, NJ 08807-2135
Phone
(908) 725-2800
Fax
(908) 704-1790
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 44SC04524000 NJ Primary

Addresses

Primary practice location

500 N Bridge St
Bridgewater, NJ 08807-2135

Mailing address

500 N Bridge St
Bridgewater, NJ 08807-2135
Phone (908) 725-2800

Other identifiers 1

IdentifierTypeStateIssuer
0023701MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20051004000114 NJ Practitioner - Clinical Social Worker 1850336926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrative Therapy Institute New JerseyGroup PAC ID 8921316605, 12 clinicians

Practice addresses (Care Compare)

206 Claremont Ave
Suite 2
Montclair, NJ 07042-3689
Phone (732) 902-2182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Therapy Institute New Jersey Clinical CurrentSince Nov 1, 2016 Accepting new patients

Locations

256 Broad St
Fl 3
Bloomfield, NJ 07003

400 New Durham Rd
Metuchen, NJ 08840
Phone (732) 482-9829

206 Claremont Ave
Ste 2
Montclair, NJ 07042
Phone (732) 902-2182

Organizations & group practices 1

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1053484642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N BRIDGE ST",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072135",
            "telephone_number": "908-725-2800",
            "fax_number": "908-704-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N BRIDGE ST",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072135",
            "telephone_number": "908-725-2800",
            "fax_number": "908-704-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINTRAUB",
        "first_name": "JAY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04524000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

Verify at the official NPI Registry.