Daniel Vincent Radom, MS, MSW, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SL06632800 Issued in NJ

Practice address

93 Stickles Pond Rd
Newton, NJ 07860-2813

Phone

(973) 383-8670

Fax

(973) 383-8676

NPI assigned

Feb 10, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bridgeway Behavioral Health ServicesGroup PAC ID 1658699715, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Bridgeway Behavioral Health Services

  • Community/Behavioral Health Agency
  • Elizabeth, NJ
  • NPI 1639294879
  Medicare reassignment Care Compare group NPD
• Bridgeway Behavioral Health Services

  • Community/Behavioral Health Agency
  • Union, NJ
  • NPI 1386781920
  NPD

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1124772827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 STICKLES POND RD",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078602813",
            "telephone_number": "973-383-8670",
            "fax_number": "973-383-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 STICKLES POND RD",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078602813",
            "telephone_number": "973-383-8670",
            "fax_number": "973-383-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOM",
        "first_name": "DANIEL",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "MS, MSW, LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL06632800",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NJ",
            "license": "44SL06632800",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06632800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://login.cbh3.crediblebh.com/Login.html?",
            "affiliation": "N",
            "endpointDescription": "credible",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ECR/ Electronic Health Record",
            "address_1": "93 Stickles Pond Rd",
            "city": "Newton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "078602813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Social Worker in Newton, NJ
• Providers in Newton, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.