Active NPI
Boni Shevelove, LSW
- Social Worker
- Montclair, NJ
National Provider Identifier
1144739012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SC05752600
- Practice address
- 129 Valley Rd FL 2
Montclair, NJ 07042-2331 - Phone
- (186) 248-5049
- Fax
- (862) 485-0493
- NPI assigned
- Sep 23, 2017
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SC05752600 | NJ | Primary |
Addresses
Primary practice location
129 Valley Rd FL 2
Montclair, NJ 07042-2331
Mailing address
41 Hillcrest Rd
West Caldwell, NJ 07006-7739
Phone (862) 485-0493
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180108001727 | NJ | Practitioner - Clinical Social Worker | 9931468410 | Practice locations: Montclair, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
129 Valley Rd
FL 2
Montclair, NJ 07042-2331
Phone (862) 485-0493
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC05752600 | NJ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507766400000",
"number": "1144739012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 HILLCREST RD",
"city": "WEST CALDWELL",
"state": "NJ",
"postal_code": "070067739",
"telephone_number": "18624850493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 VALLEY RD FL 2",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070422331",
"telephone_number": "186-248-5049",
"fax_number": "862-485-0493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEVELOVE",
"first_name": "BONI",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-23",
"last_updated": "2017-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SC05752600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.