Active NPI
John Carlos Abreu, LCSW
- Clinical Social Worker
- Bronx, NY
National Provider Identifier
1063992212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 091736
- Practice address
- 1420 Ferris PL
Bronx, NY 10461-3611 - Phone
- (718) 239-1610
- NPI assigned
- Aug 17, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 091736 | NY | Primary |
Addresses
Primary practice location
1420 Ferris PL
Bronx, NY 10461-3611
Mailing address
100 Fisher Ave Ste 412
White Plains, NY 10606-1919
Phone (845) 600-4244
Other practice location 1
100 Fisher avenue
Ste 412
White Plains, NY 10606
Phone (646) 342-2234
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 091736 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shine Medical Providers PC | Past | Accepting new patients |
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.
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- NPI 1538894050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651449600000",
"number": "1063992212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 FISHER AVE STE 412",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106061919",
"telephone_number": "845-600-4244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 FERRIS PL",
"city": "BRONX",
"state": "NY",
"postal_code": "104613611",
"telephone_number": "718-239-1610"
}
],
"practiceLocations": [
{
"address_1": "100 Fisher avenue",
"address_2": "Ste 412",
"address_purpose": "LOCATION",
"city": "White Plains",
"state": "NY",
"postal_code": "10606",
"country_code": "US",
"telephone_number": "646-342-2234",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ABREU",
"first_name": "JOHN",
"middle_name": "CARLOS",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-17",
"last_updated": "2022-05-02",
"certification_date": "2022-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "091736",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Other",
"affiliation": "N",
"address_1": "100 Fisher avenue",
"address_2": "Ste 412",
"city": "White Plains",
"state": "NY",
"country_code": "US",
"postal_code": "10606",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.