Active NPI
Jose Jorge, LMSW
- Social Worker
- Long Island City, NY
National Provider Identifier
1124375381
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Sep 20, 2016.
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 083676
- Practice address
- 2976 Northern Blvd
Long Island City, NY 11101-2822 - Phone
- (347) 510-3642
- Fax
- (347) 510-3457
- NPI assigned
- Aug 7, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 083676 | NY | Primary |
Addresses
Primary practice location
2976 Northern Blvd
Long Island City, NY 11101-2822
Mailing address
29-76 Northern Blvd
Long Island City, NY 11101-2822
Phone (347) 510-3642
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 083676 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344988800000",
"number": "1124375381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29-76 NORTHERN BLVD",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111012822",
"telephone_number": "347-510-3642",
"fax_number": "347-510-3457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2976 NORTHERN BLVD",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111012822",
"telephone_number": "347-510-3642",
"fax_number": "347-510-3457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORGE",
"first_name": "JOSE",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-07",
"last_updated": "2012-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "083676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Island City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.