Individual provider Active NPI

John Pettinato

  • Social Worker
  • Bronx, NY
National Provider Identifier
1215387568
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
039006-1 Issued in NY
Practice address
521 W 239TH St
Bronx, NY 10463-1205
Phone
(917) 743-1572
NPI assigned
Jun 17, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 039006-1 NY Primary

Addresses

Primary practice location

521 W 239TH St
Bronx, NY 10463-1205

Mailing address

521 W 239TH St
Bronx, NY 10463-1205
Phone (917) 743-1572

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
I20170201000064 NY Practitioner - Clinical Social Worker 6204118086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

521 W 239TH St
Bronx, NY 10463-1205
Phone (718) 601-2280

Merit-based Incentive Payment System (MIPS)

Final score
87.65 of 100Reported as group
Quality
71.56
Promoting interoperability
74
Improvement activities
40
Cost
87.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039006-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board of Family and Children'S Services, Inc. CurrentSince Nov 29, 2016 Accepting new patients
Jewish Board of Family & Childrens Services Inc CurrentSince Nov 29, 2016 Accepting new patients

Locations

521 W 239th St
Bronx, NY 10463
Phone (718) 601-2280

1273 53rd St
Brooklyn, NY 11219
Phone (718) 435-5700

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": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1215387568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 W 239TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104631205",
            "telephone_number": "917-743-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 W 239TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104631205",
            "telephone_number": "917-743-1572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINATO",
        "first_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-17",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "039006-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.