Active NPI
Pamela Busch Jimenez
- Clinical Social Worker
- Greenwich, CT
National Provider Identifier
1134818446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12996
- Practice address
- 500 W Putnam Ave Ste 400
Greenwich, CT 06830-6096 - Phone
- (203) 570-1444
- NPI assigned
- May 3, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 12996 | CT | Primary |
Addresses
Primary practice location
500 W Putnam Ave Ste 400
Greenwich, CT 06830-6096
Mailing address
10 Gilliam LN
Riverside, CT 06878-2204
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 1, 2026 through Mar 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12996 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683072000000",
"number": "1134818446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 GILLIAM LN",
"city": "RIVERSIDE",
"state": "CT",
"postal_code": "068782204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W PUTNAM AVE STE 400",
"city": "GREENWICH",
"state": "CT",
"postal_code": "068306096",
"telephone_number": "203-570-1444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "PAMELA",
"middle_name": "BUSCH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-03",
"last_updated": "2023-05-03",
"certification_date": "2023-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "12996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.