Individual provider Active NPI

Shneur Zalman Marshall

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1063889889
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
5750 Park Heights Ave
Baltimore, MD 21215-3930
Phone
(410) 446-9200
NPI assigned
Aug 27, 2015
Last updated
Jan 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

5750 Park Heights Ave
Baltimore, MD 21215-3930

Mailing address

5750 Park Heights Ave
Baltimore, MD 21215-3930

Other practice location 1

1273 53rd St
4th Floor
Brooklyn, NY 11219-3865
Phone (718) 435-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20190205002993 MD Practitioner - Clinical Social Worker 1355689019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5750 Park Heights Ave
Baltimore, MD 21215-3930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22077MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Community Services, Inc Clinical CurrentSince Jan 9, 2019 Accepting new patients
Upper Bay Counseling and Support Services, Inc CurrentSince Jan 9, 2019 Accepting new patients
Upper Bay Counseling & Support Services, Inc. CurrentSince Jan 9, 2019 Accepting new patients

Locations

5750 Park Heights Ave
Baltimore, MD 21215
Phone (410) 466-9200

200 Booth St
Elkton, MD 21921
Phone (410) 996-3400

3506 Gwynnbrook Ave
Owings Mills, MD 21117
Phone (410) 466-9200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1063889889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 PARK HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212153930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 PARK HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212153930",
            "telephone_number": "410-446-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1273 53rd St",
            "address_2": "4th Floor",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112193865",
            "country_code": "US",
            "telephone_number": "718-435-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "SHNEUR",
        "middle_name": "ZALMAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.