Individual provider Active NPI

Kenneth Moskowitz, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1184647562
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10684C Issued in NV
Practice address
5851 W Charleston Blvd
Las Vegas, NV 89146
Phone
(702) 732-0304
Fax
(702) 794-2033
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW2796 FL
Clinical Social Worker 1041C0700X 10684C NV Primary

Addresses

Primary practice location

5851 W Charleston Blvd
Las Vegas, NV 89146

Mailing address

2408 Rue Bienville Way
Henderson, NV 89044
Phone (954) 907-0383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20240625000896 NV Practitioner - Clinical Social Worker 6204897077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Stony Brook, School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jewish Family Service AgencyGroup PAC ID 1456320142, 3 clinicians

Practice addresses (Care Compare)

5851 W Charleston Blvd
Las Vegas, NV 89146-1290
Phone (702) 732-0304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW2796FLMDClinical Social Worker
10684CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Service Agency CurrentSince Apr 28, 2024 Accepting new patients
Dr Stanley and Pearl Goodman JFS of Broward County Inc Clinical PastSince Jul 1, 1990 Accepting new patients

Locations

5851 W Charleston Blvd
Las Vegas, NV 89146
Phone (702) 732-0304

Organizations & group practices 2

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1184647562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 RUE BIENVILLE WAY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89044",
            "telephone_number": "954-907-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5851 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89146",
            "telephone_number": "702-732-0304",
            "fax_number": "702-794-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSKOWITZ",
        "first_name": "KENNETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW2796",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "10684C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.