Individual provider Active NPI

Tobi Elizabeth Peck, L.CSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1104965581
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0505871-1 Issued in NY
Practice address
26 Court St
Suite 410
Brooklyn, NY 11242-0103
Phone
(212) 613-3006
Fax
(212) 691-8683
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
Yes

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 R0505871-1 NY Primary

Addresses

Primary practice location

26 Court St
Suite 410
Brooklyn, NY 11242-0103

Mailing address

684 Washington St
Apt. 4a
New York, NY 10014-2507
Phone (212) 613-3006

Other identifiers 5

IdentifierTypeStateIssuer
143633OtherNYVALUE OPTIONS
278853POtherNYHIP HEALTH PLAN OF NY
7480180OtherNYGHI
P2626464OtherNYOXFORD
R050871-1OtherNYLCSW

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
I20140611000539 NY Practitioner - Clinical Social Worker 4284858374 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

26 Court St
Brooklyn, NY 11242-1134
Phone (212) 613-3006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0505871-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104965581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "684 WASHINGTON ST",
            "address_2": "APT. 4A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100142507",
            "telephone_number": "212-613-3006",
            "fax_number": "212-691-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 COURT ST",
            "address_2": "SUITE 410",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112420103",
            "telephone_number": "212-613-3006",
            "fax_number": "212-691-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "TOBI",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "L.CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0505871-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "143633",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP HEALTH PLAN OF NY",
            "identifier": "278853P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7480180",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2626464",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "R050871-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.