Individual provider Active NPI

Beverly Hoffman

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1063434355
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R030128 Issued in NY
Practice address
333 E 49TH St
Suite Lobby a
New York, NY 10017-1680
Phone
(212) 751-8020
Fax
(631) 754-7013
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 R030128 NY Primary

Addresses

Primary practice location

333 E 49TH St
Suite Lobby a
New York, NY 10017-1680

Mailing address

114 Soundview Ter
Northport, NY 11768-1230
Phone (631) 754-0094

Other identifiers 3

IdentifierTypeStateIssuer
4527337OtherNYAETNA ID
37344POtherNYHIP ID
136091POtherNYHIP ID

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
I20110114000181 NY Practitioner - Clinical Social Worker 4981893468 Practice locations: New York, NY; Northport, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

114 Soundview Ter
Northport, NY 11768-1230
Phone (631) 754-7013

114 Soundview Terrace
Northport, NY 11768-1230

333 E 49TH St K
New York, NY 10017-1609
Phone (212) 751-8020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R030128NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063434355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 SOUNDVIEW TER",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681230",
            "telephone_number": "631-754-0094",
            "fax_number": "631-754-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E 49TH ST",
            "address_2": "SUITE LOBBY A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100171680",
            "telephone_number": "212-751-8020",
            "fax_number": "631-754-7013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "BEVERLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R030128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID",
            "identifier": "4527337",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP ID",
            "identifier": "37344P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP ID",
            "identifier": "136091P",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.