Individual provider Active NPI

Madeleine Shair, LCSW

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1063652691
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3380 Reservoir Oval
School Based Health Center
Bronx, NY 10467-3101
Phone
(718) 696-4060
NPI assigned
Feb 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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 Primary

Addresses

Primary practice location

3380 Reservoir Oval
School Based Health Center
Bronx, NY 10467-3101

Mailing address

7 Minor CT
West Nyack, NY 10994-1110

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
I20181109001796 NY Practitioner - Clinical Social Worker 7416201413 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Medical PCGroup PAC ID 4082089461, 64 clinicians

Practice addresses (Care Compare)

2263 James St
Suite 523
Syracuse, NY 13206-3262
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Sep 15, 2018 Accepting new patients
Montefiore Medical Center CurrentSince Sep 15, 2018 Accepting new patients
Brightside Medical, P.C. CurrentSince Nov 1, 2023 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

111 E 210th St
Bronx, NY 10467

3380 Reservoir Oval E
Bronx, NY 10467
Phone (718) 430-6375

Organizations & group practices 3

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": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1063652691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MINOR CT",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109941110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 RESERVOIR OVAL",
            "address_2": "SCHOOL BASED HEALTH CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104673101",
            "telephone_number": "718-696-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAIR",
        "first_name": "MADELEINE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-23",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.