Individual provider Active NPI

Emilio Iturrino

  • Clinical Social Worker
  • Forest Hills, NY
National Provider Identifier
1174806814
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
084070-1 Issued in NY
Practice address
10470 Queens Blvd
Suite 200
Forest Hills, NY 11375
Phone
(718) 275-6010
Fax
(718) 275-6062
NPI assigned
Sep 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 084070-1 NY Primary

Addresses

Primary practice location

10470 Queens Blvd
Suite 200
Forest Hills, NY 11375

Mailing address

9114 37TH Ave
Jackson Heights, NY 11372-7920
Phone (718) 779-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160725001109 NY Practitioner - Clinical Social Worker 7810280104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
New York University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sun River Health Inc.Group PAC ID 6608783568, 246 clinicians
Community Counseling and MediationGroup PAC ID 5294960936, 12 clinicians

Practice addresses (Care Compare)

1037 Main St
Peekskill, NY 10566-2913
Phone (914) 734-8800

1200 Brown St
Peekskill, NY 10566-2913

25 Elm PL
FL 2
Brooklyn, NY 11201-5355
Phone 7188020666243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
084070-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc CurrentSince Mar 23, 2024 Accepting new patients
Sun River Health Inc. CurrentSince Mar 23, 2024 Accepting new patients
Sun River Health Inc Current Accepting new patients
Bleuler Psychotherapy Center, Inc. PastSince Mar 10, 1999 Accepting new patients
Catholic Charities Neigborhood Services Clinical Past Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

6 Henry St
Beacon, NY 12508
Phone (845) 831-0400

10504 Sutphin Blvd
Jamaica, NY 11435
Phone (718) 725-5000

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/bleulerpc/r4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1174806814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9114 37TH AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727920",
            "telephone_number": "718-779-1600",
            "fax_number": "718-779-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10470 QUEENS BLVD",
            "address_2": "SUITE 200",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-275-6010",
            "fax_number": "718-275-6062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITURRINO",
        "first_name": "EMILIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-20",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084070-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.