Individual provider Active NPI

Gloria Burth, LCSW

  • Clinical Social Worker
  • Elmhurst, NY
National Provider Identifier
1104912898
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P055498-1 Issued in NY
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
055498-A37OtherNYHEALTHFIRST

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140107000353 NY Order and Referring Only - Clinical Social Worker 7012951767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P055498-1NYMDClinical Social Worker
055498NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.