Individual provider Active NPI

Jean S Devlin, LMSW

  • Social Worker
  • Saratoga Springs, NY
National Provider Identifier
1053601658
Registry record updated Apr 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
064778-1 Issued in NY
Practice address
211 Church St
Cramer House
Saratoga Springs, NY 12866-1003
Phone
(518) 584-9030
Fax
(518) 581-1709
NPI assigned
Apr 15, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2011

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 064778-1 NY Primary

Addresses

Primary practice location

211 Church St
Cramer House
Saratoga Springs, NY 12866-1003

Mailing address

211 Church St
Cramer House
Saratoga Springs, NY 12866-1003
Phone (518) 584-9030

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
I20140225000372 NY Practitioner - Clinical Social Worker 9830329515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saratoga CountyGroup PAC ID 7810983012, 19 clinicians

Practice addresses (Care Compare)

135 S Broadway
Saratoga Springs, NY 12866-4532
Phone 51858490301051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
064778-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga County CurrentSince Jan 4, 2014 Accepting new patients
Saratoga County CurrentSince Jan 4, 2014 Accepting new patients

Locations

135 S Broadway
Saratoga Springs, NY 12866
Phone (518) 584-9030

Organizations & group practices 2

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": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302825600000",
    "number": "1053601658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 CHURCH ST",
            "address_2": "CRAMER HOUSE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661003",
            "telephone_number": "518-584-9030",
            "fax_number": "518-581-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 CHURCH ST",
            "address_2": "CRAMER HOUSE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661003",
            "telephone_number": "518-584-9030",
            "fax_number": "518-581-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVLIN",
        "first_name": "JEAN",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-15",
        "last_updated": "2011-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "064778-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.