Individual provider Active NPI

Elsa De Leon, LMSW

  • Social Worker
  • Long Island City, NY
National Provider Identifier
1114473675
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
097003 Issued in NY
Practice address
3602 14TH St
Long Island City, NY 11106-4704
Phone
(718) 392-2510
Fax
(718) 392-2637
NPI assigned
Aug 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 097003 NY Primary

Addresses

Primary practice location

3602 14TH St
Long Island City, NY 11106-4704

Mailing address

3602 14TH St
Long Island City, NY 11106-4704
Phone (718) 392-2510

Other practice location 1

9114 37th Ave
Jackson Heights, NY 11372-7920
Phone (718) 779-1600

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
I20240610001562 NY Practitioner - Clinical Social Worker 1254873920 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
097003NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brooklyn Center for Families in Crisis CurrentSince Apr 28, 2024 Accepting new patients

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": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1114473675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3602 14TH ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111064704",
            "telephone_number": "718-392-2510",
            "fax_number": "718-392-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 14TH ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111064704",
            "telephone_number": "718-392-2510",
            "fax_number": "718-392-2637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9114 37th Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson Heights",
            "state": "NY",
            "postal_code": "113727920",
            "country_code": "US",
            "telephone_number": "718-779-1600",
            "fax_number": "347-612-4162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "ELSA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "097003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.