Individual provider Active NPI

Tamiris Angela Booth

  • Social Worker
  • Montrose, NY
National Provider Identifier
1093480774
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
110883 Issued in NY
Practice address
2094 Albany Post Rd
Montrose, NY 10548-1454
Phone
(914) 737-4400
NPI assigned
Aug 13, 2021
Last updated
Aug 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 110883 NY Primary

Addresses

Primary practice location

2094 Albany Post Rd
Montrose, NY 10548-1454

Mailing address

2094 Albany Post Rd
Montrose, NY 10548-1454
Phone (914) 737-4400

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
I20251107000573 NY Practitioner - Clinical Social Worker 2567952518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

256 Washington St
Suite 2
Mount Vernon, NY 10553-1056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110883NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Guidance Center of Westchester, Inc CurrentSince Aug 18, 2025 Accepting new patients

Locations

256 Washington St
Ste 2
Mount Vernon, NY 10553
Phone 91461307003338

20 Sickles Ave
New Rochelle, NY 10801
Phone (914) 632-1374

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, 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": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1093480774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2094 ALBANY POST RD",
            "city": "MONTROSE",
            "state": "NY",
            "postal_code": "105481454",
            "telephone_number": "914-737-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2094 ALBANY POST RD",
            "city": "MONTROSE",
            "state": "NY",
            "postal_code": "105481454",
            "telephone_number": "914-737-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "TAMIRIS",
        "middle_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "110883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, NY

Sources for this page

Verify at the official NPI Registry.