Individual provider Active NPI

Glorimari Jimenez

  • Clinical Social Worker
  • Ponce, PR
National Provider Identifier
1205222726
Registry record updated Apr 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10461 Issued in PR
Practice address
2118 Calle Drama
Urb San Antonio
Ponce, PR 00728
Phone
(787) 929-4102
NPI assigned
Apr 10, 2015
Last updated
Apr 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10461 PR Primary

Addresses

Primary practice location

2118 Calle Drama
Urb San Antonio
Ponce, PR 00728

Mailing address

Urb. San Antonio
Calle Drama 2118
Ponce, PUERTO RICO 00728
UM
Phone (787) 929-4102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20260626003045 PR Practitioner - Clinical Social Worker 0446723761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

411 Calle Antonio R Barcelo
Penuelas, PR 00624

Reparto Anaida
Calle E3 Palma Real
Ponce, PR 00716-2509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10461PRMDClinical Social Worker

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428624000000",
    "number": "1205222726",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "URB. SAN ANTONIO",
            "address_2": "CALLE DRAMA 2118",
            "city": "PONCE",
            "state": "PUERTO RICO",
            "postal_code": "00728",
            "telephone_number": "787-929-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 CALLE DRAMA",
            "address_2": "URB SAN ANTONIO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00728",
            "telephone_number": "787-929-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "GLORIMARI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2015-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "10461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.