Individual provider Active NPI

Christopher Gervasi

  • Social Worker
  • Bronx, NY
National Provider Identifier
1174260061
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
579 Courtlandt Ave
Bronx, NY 10451-5013
Phone
(718) 485-2100
NPI assigned
May 12, 2022
Last updated
May 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NY Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

579 Courtlandt Ave
Bronx, NY 10451-5013

Mailing address

91 E 208TH St Apt 3H
Bronx, NY 10467-2766
Phone (347) 552-6984

Other practice location 1

91 E 208th St Apt 3H
Bronx, NY 10467-2766
Phone (347) 552-6984

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1174260061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 E 208TH ST APT 3H",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672766",
            "telephone_number": "347-552-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 COURTLANDT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515013",
            "telephone_number": "718-485-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 E 208th St Apt 3H",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672766",
            "country_code": "US",
            "telephone_number": "347-552-6984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERVASI",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-12",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.