Active NPI
Jennifer Gurtman, LCSW
- Clinical Social Worker
- Elmhurst, NY
National Provider Identifier
1154675759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 084394
- Practice address
- 7901 Broadway
Elmhurst, NY 11373-1329 - Phone
- (718) 334-2271
- NPI assigned
- Nov 4, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 079663-1 | NY | |
| Clinical Social Worker | 1041C0700X | 084394 | NY | Primary |
Addresses
Primary practice location
7901 Broadway
Elmhurst, NY 11373-1329
Mailing address
7901 Broadway
Elmhurst, NY 11373-1329
Phone (718) 334-2271
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 079663-1 | NY | MD | Clinical Social Worker |
| 084394 | NY | MD | Clinical Social Worker |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618531200000",
"number": "1154675759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7901 BROADWAY",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731329",
"telephone_number": "718-334-2271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7901 BROADWAY",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731329",
"telephone_number": "718-334-2271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GURTMAN",
"first_name": "JENNIFER",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-04",
"last_updated": "2021-04-16",
"certification_date": "2021-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "079663-1",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "084394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.