Individual provider Active NPI

Sandra Taitt, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1104297126
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
091941 Issued in NY
Practice address
5800 3Rd Ave
Brooklyn, NY 11220-3702
Phone
(718) 630-8298
Fax
(718) 630-7437
NPI assigned
Oct 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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 077818 NY
Clinical Social Worker 1041C0700X 091941 NY Primary

Addresses

Primary practice location

5800 3Rd Ave
Brooklyn, NY 11220-3702

Mailing address

5800 3Rd Ave
Brooklyn, NY 11220-3702
Phone (718) 630-8298

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
I20220124000867 NY Practitioner - Clinical Social Worker 5991197097 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals CurrentSince Oct 21, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Apr 23, 2022 Accepting new patients
NYU Langone Hospitals CurrentSince Oct 21, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Apr 23, 2022 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

100 Corporate Dr
#100
Yonkers, NY 10701

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 4

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": "1444953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1104297126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 3RD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203702",
            "telephone_number": "718-630-8298",
            "fax_number": "718-630-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 3RD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203702",
            "telephone_number": "718-630-8298",
            "fax_number": "718-630-7437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAITT",
        "first_name": "SANDRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-16",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "077818",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.