Active NPI
Gloria Burth, LCSW
- Clinical Social Worker
- Elmhurst, NY
National Provider Identifier
1104912898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P055498-1
- Practice address
- 75-01 Broadway 3Rd FL
Elmhurst, NY 11373 - Phone
- (718) 478-1554
- Fax
- (718) 478-3844
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- 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 | P055498-1 | NY | Primary |
Addresses
Primary practice location
75-01 Broadway 3Rd FL
Elmhurst, NY 11373
Mailing address
63-85 Woodhaven Blvd
Apt 6H
Rego Park, NY 11374-4850
Phone (718) 478-1554
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 055498-A37 | Other | NY | HEALTHFIRST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140107000353 | NY | Order and Referring Only - Clinical Social Worker | 7012951767 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P055498-1 | NY | MD | Clinical Social Worker |
| 055498 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institute for the Puerto Rican Hispanic Elderly Inc. | Clinical | Past | Accepting new patients |
| Steinway Child and Family Services, Inc. | Clinical | Past | Accepting new patients |
| Samuel Field Ym&Ywha | Past | Accepting new patients | |
| Steinway Child and Family Services, Inc | Clinical | Past | Accepting new patients |
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.
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- Clinical Social Worker
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-
- Adult Mental Health Clinic/Center
- Little Neck, NY
- NPI 1205862950
-
- Clinical Social Worker
- Howard Beach, NY
- NPI 1346286382
-
- Clinical Social Worker
- Long Island City, NY
- NPI 1801844584
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104912898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63-85 WOODHAVEN BLVD",
"address_2": "APT 6H",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113744850",
"telephone_number": "718-478-1554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75-01 BROADWAY 3RD FL",
"city": "ELMHURST",
"state": "NY",
"postal_code": "11373",
"telephone_number": "718-478-1554",
"fax_number": "718-478-3844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURTH",
"first_name": "GLORIA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "P055498-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHFIRST",
"identifier": "055498-A37",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.