Individual provider Active NPI

Suhang Duan

  • Social Worker
  • New York, NY
National Provider Identifier
1104498815
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
112953 Issued in NY
Practice address
465 Grand St
New York, NY 10002-4800
Phone
(646) 645-8070
Fax
(212) 420-1906
NPI assigned
Jul 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 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 112953 NY Primary

Addresses

Primary practice location

465 Grand St
New York, NY 10002-4800

Mailing address

465 Grand St
New York, NY 10002-4800
Phone (646) 645-8070

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
I20250206002127 NY Practitioner - Clinical Social Worker 4082144043 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112953NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Assistance Resources & Extended Services Inc CurrentSince Dec 24, 2024 Accepting new patients

Locations

465 Grand St
New York, NY 10002
Phone (212) 420-1970

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.

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1104498815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 GRAND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024800",
            "telephone_number": "646-645-8070",
            "fax_number": "212-420-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 GRAND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024800",
            "telephone_number": "646-645-8070",
            "fax_number": "212-420-1906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUAN",
        "first_name": "SUHANG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "112953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.