Active NPI
Ted I Nelson, LCSW
- Clinical Social Worker
- Bronx, NY
National Provider Identifier
1184002404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 074712-1
- Practice address
- 1050 Allerton Ave
Bronx, NY 10469-4421 - Phone
- (347) 261-3642
- NPI assigned
- May 7, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 074712-1 | NY | Primary |
Addresses
Primary practice location
1050 Allerton Ave
Bronx, NY 10469-4421
Mailing address
1050 Allerton Ave
Bronx, NY 10469-4421
Phone (347) 261-3642
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181210001770 | NY | Practitioner - Clinical Social Worker | 2466796974 | Practice locations: New York, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1990
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2 Ellwood St
Apt 4BB
New York, NY 10040-1920
Phone (347) 344-9807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 074712-1 | NY | MD | Clinical Social Worker |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430956800000",
"number": "1184002404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 ALLERTON AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104694421",
"telephone_number": "347-261-3642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 ALLERTON AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104694421",
"telephone_number": "347-261-3642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "TED",
"middle_name": "I",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-07",
"last_updated": "2015-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "074712-1",
"primary": true
}
],
"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 7, 2015; 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.