NPIMap

Organization Active NPI

Kimberly Hertz LCSW P.L.L.C

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1104466440
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
KIMBERLY HERTZ LCSW P.L.L.C
Practice address
125 E 23Rd St Ste 400
New York, NY 10010-4582
Phone
(212) 951-0947
NPI assigned
Jan 15, 2020
Last updated
Jan 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Authorized official

Name
Kimberly Hertz, LCSW-RNPI 1801236211
Title
Supervisor/Owner
Phone
(212) 951-0947

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

125 E 23Rd St Ste 400
New York, NY 10010-4582

Mailing address

125 E 23Rd St Ste 400
New York, NY 10010-4582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240424001374 NY Part B Supplier - Clinic/Group Practice 3476993460 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

125 E 23rd St
Ste 400
New York, NY 10010
Phone (212) 951-0947

125 E 23rd St
Ste 501
New York, NY 10010
Phone (212) 433-2664

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1104466440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E 23RD ST STE 400",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E 23RD ST STE 400",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104582",
            "telephone_number": "212-951-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY HERTZ LCSW P.L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "HERTZ",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SUPERVISOR/OWNER",
        "authorized_official_telephone_number": "212-951-0947",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.