Individual provider Active NPI

Yakov Buxbaum, LCSW

  • Clinical Social Worker
  • Spring Valley, NY
National Provider Identifier
1053981936
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
091644 Issued in NY
Practice address
12 Jackson Ave
Spring Valley, NY 10977-1908
Phone
(845) 270-4578
Fax
(845) 675-4987
NPI assigned
Jul 1, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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 091644 NY Primary

Addresses

Primary practice location

12 Jackson Ave
Spring Valley, NY 10977-1908

Mailing address

19 Taft LN # 201
Spring Valley, NY 10977-1924
Phone (845) 270-4578

Other names 1

  • Yakov Buxbaum Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • 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
I20250506001339 NY Practitioner - Clinical Social Worker 1658898481 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Assistance Resources & Extended Services Inc CurrentSince Feb 3, 2025 Accepting new patients

Locations

465 Grand St
New York, NY 10002
Phone (212) 420-1970

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": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1053981936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 TAFT LN # 201",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109771924",
            "telephone_number": "845-270-4578",
            "fax_number": "845-675-4987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 JACKSON AVE",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109771908",
            "telephone_number": "845-270-4578",
            "fax_number": "845-675-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUXBAUM",
        "first_name": "YAKOV",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YAKOV",
            "last_name": "BUXBAUM",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spring Valley, NY

Sources for this page

Verify at the official NPI Registry.