Individual provider Active NPI

Madison Skudlarek

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1215518832
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089812 Issued in NY
Practice address
109 E 115TH St
New York, NY 10029-1186
Phone
(212) 633-9300
NPI assigned
Apr 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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 089812 NY Primary

Addresses

Primary practice location

109 E 115TH St
New York, NY 10029-1186

Mailing address

590 Avenue of Americas
New York, NY 10011

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://nppes.cms.hhs.gov/images/info.png

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
I20250430000770 NY Practitioner - Clinical Social Worker 1658897970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Witkes LCSW PCGroup PAC ID 7416314182, 2 clinicians

Practice addresses (Care Compare)

1154 Sterling PL
Brooklyn, NY 11213-2607
Phone (216) 600-7278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
089812NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Witkes LCSW PC Clinical CurrentSince Feb 18, 2025 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1215518832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 AVENUE OF AMERICAS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E 115TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100291186",
            "telephone_number": "212-633-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKUDLAREK",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-15",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://nppes.cms.hhs.gov/images/info.png",
            "affiliation": "N",
            "address_1": "109 E 115th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100291186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.