Individual provider Active NPI

Rae Berss Winderbaum, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1205986908
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0355501 Issued in NY
Practice address
600 Columbus Avenue
# 12G
New York, NY 10024-1440
Phone
(212) 721-2273
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R0355501 NY Primary

Addresses

Primary practice location

600 Columbus Avenue
# 12G
New York, NY 10024-1440

Mailing address

600 Columbus Avenue
# 12G
New York, NY 10024-1440
Phone (212) 721-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0355501NYMDClinical Social Worker
035550NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205986908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COLUMBUS AVENUE",
            "address_2": "# 12G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100241440",
            "telephone_number": "212-721-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COLUMBUS AVENUE",
            "address_2": "# 12G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100241440",
            "telephone_number": "212-721-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDERBAUM",
        "first_name": "RAE",
        "middle_name": "BERSS",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0355501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.