Individual provider Active NPI

Shelly D'Amato, LCSW

  • Social Worker
  • Roseland, NJ
National Provider Identifier
1144710054
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
14 Pacio CT
Roseland, NJ 07068-1121
Phone
(201) 245-4014
NPI assigned
May 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 44SC05941400 NJ
Social Worker 104100000X Primary

Addresses

Primary practice location

14 Pacio CT
Roseland, NJ 07068-1121

Mailing address

14 Pacio CT
Roseland, NJ 07068-1121
Phone (201) 245-4014

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200923000705 NJ Practitioner - Clinical Social Worker 3971922089 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14 Pacio CT
Roseland, NJ 07068-1121
Phone (862) 352-8683

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shelly D'Amato LLC Single Specialty CurrentSince May 1, 2024 Accepting new patients
Care Plus NJ Inc. CurrentSince Sep 11, 2020 Accepting new patients
Care Plus NJ, Inc CurrentSince Sep 11, 2020 Accepting new patients
Care Plus NJ, Inc. Single Specialty Current Accepting new patients

Locations

610 Valley Health Plz
Paramus, NJ 07652
Phone (201) 797-2660

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": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1144710054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PACIO CT",
            "city": "ROSELAND",
            "state": "NJ",
            "postal_code": "070681121",
            "telephone_number": "201-245-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 PACIO CT",
            "city": "ROSELAND",
            "state": "NJ",
            "postal_code": "070681121",
            "telephone_number": "201-245-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AMATO",
        "first_name": "SHELLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05941400",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseland, NJ

Sources for this page

Verify at the official NPI Registry.