Individual provider Active NPI

Manuel Velez Colon, LCSWR

  • Clinical Social Worker
  • Buffalo, NY
National Provider Identifier
1124226717
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R040050 Issued in NY
Practice address
80 Goodrich St
Buffalo, NY 14203-1005
Phone
(716) 859-3932
NPI assigned
Jul 5, 2007
Sex
Male
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 R040050 NY Primary

Addresses

Primary practice location

80 Goodrich St
Buffalo, NY 14203-1005

Mailing address

56 Allison Dr
Cheektowaga, NY 14225-2502
Phone (716) 894-3502

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
I20051206000734 NY Practitioner - Clinical Social Worker 7214957125 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R040050NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service of the Chautauqua Region Inc Clinical CurrentSince Jun 13, 2018 Accepting new patients
Chautauqua County Chapter of Nysarc Inc CurrentSince Nov 10, 2017 Accepting new patients
Chautauqua Co. Chapter of Nysarc Inc Dba the Resource Center Current Accepting new patients
Chautauqua County Chapter of Nysarc Inc CurrentSince Nov 10, 2017 Accepting new patients

Locations

186 Lake Shore Dr W
Dunkirk, NY 14048
Phone (716) 366-6125

332 E 4th St
Jamestown, NY 14701
Phone (716) 488-1971

200 Dunham Ave
Jamestown, NY 14701
Phone (716) 661-1400

890 E 2nd St
Jamestown, NY 14701
Phone (716) 661-1447

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124226717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 ALLISON DR",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142252502",
            "telephone_number": "716-894-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 GOODRICH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031005",
            "telephone_number": "716-859-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON",
        "first_name": "MANUEL",
        "middle_name": "VELEZ",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R040050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.