Individual provider Active NPI

Ruth Rothbart-Mayer, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1104997394
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R014647 Issued in NY
Practice address
441 W End Ave Apt 1B
New York, NY 10024-5327
Phone
(212) 579-9708
NPI assigned
Nov 11, 2006
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R014647 NY Primary
Clinical Social Worker 1041C0700X 44SC00535700 NJ

Addresses

Primary practice location

441 W End Ave Apt 1B
New York, NY 10024-5327

Mailing address

14 Fairway Ave
West Orange, NJ 07052-2205
Phone (973) 731-7357

Other identifiers 1

IdentifierTypeStateIssuer
7404700OtherNYGHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100513000290 NJ Practitioner - Clinical Social Worker 0648308577 Practice locations: West Orange, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14 Fairway Ave
West Orange, NJ 07052-2205
Phone (917) 916-8002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014647NYMDMental Health Counselor
R014647NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104997394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FAIRWAY AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522205",
            "telephone_number": "973-731-7357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 W END AVE APT 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245327",
            "telephone_number": "212-579-9708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBART-MAYER",
        "first_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R014647",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00535700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7404700",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.