Individual provider Active NPI

Yvette Gonzalez, MSW

  • Clinical Social Worker
  • Ozone Park, NY
National Provider Identifier
1063624609
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R076003-1 Issued in NY
Practice address
9749 Woodhaven Blvd Ste 2
Ozone Park, NY 11416
Phone
(718) 323-9460
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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 R076003-1 NY Primary

Addresses

Primary practice location

9749 Woodhaven Blvd Ste 2
Ozone Park, NY 11416

Mailing address

103-23 Plattwood Ave
Ozone Park, NY 11417
Phone (718) 323-3819

Other names 1

  • Ms. Yvette Abelong Former name

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
I20190201002283 NY Practitioner - Clinical Social Worker 4789921495 Practice locations: Ozone Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9749 Woodhaven Blvd
Suite 2
Ozone Park, NY 11416-2312
Phone (718) 323-9460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R076003-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1063624609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103-23 PLATTWOOD AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "11417",
            "telephone_number": "718-323-3819",
            "fax_number": "718-323-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9749 WOODHAVEN BLVD STE 2",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "11416",
            "telephone_number": "718-323-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "YVETTE",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R076003-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YVETTE",
            "last_name": "ABELONG",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ozone Park, NY

Sources for this page

Verify at the official NPI Registry.