Active NPI
Cal Klingensmith Shields, LCSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1053665638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 083627
- Practice address
- 142 E 27TH St Suite 1a
New York, NY 10016-9057 - Phone
- (929) 259-2059
- NPI assigned
- Nov 3, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 083627 | NY | Primary |
| Social Worker | 104100000X | 086888 | NY |
Addresses
Primary practice location
142 E 27TH St Suite 1a
New York, NY 10016-9057
Mailing address
142 E 27TH St Apt 1a
New York, NY 10016-9057
Phone (929) 259-2059
Other practice location 1
750 Tilden St
Bronx, NY 10467-6013
Phone (718) 231-3400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03517411 | Medicaid | NY |
Other names 1
- Carolyn Lindsay Shields Klingensmith
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 086888 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628121600000",
"number": "1053665638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "142 E 27TH ST APT 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100169057",
"telephone_number": "929-259-2059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 E 27TH ST SUITE 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100169057",
"telephone_number": "929-259-2059"
}
],
"practiceLocations": [
{
"address_1": "750 Tilden St",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104676013",
"country_code": "US",
"telephone_number": "718-231-3400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KLINGENSMITH SHIELDS",
"first_name": "CAL",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-11-03",
"last_updated": "2021-08-05",
"certification_date": "2021-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "083627",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "086888",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03517411",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CAROLYN",
"last_name": "KLINGENSMITH",
"middle_name": "LINDSAY SHIELDS",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.