Active NPI
Herbert Bardavid, MSW
- Clinical Social Worker
- Great Neck, NY
National Provider Identifier
1215953120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R017580
- Practice address
- 5 Shadow LN
Great Neck, NY 11021-2510 - Phone
- (516) 829-6931
- Fax
- (516) 466-6541
- NPI assigned
- Jul 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R017580 | NY | Primary |
Addresses
Primary practice location
5 Shadow LN
Great Neck, NY 11021-2510
Mailing address
5 Shadow LN
Great Neck, NY 11021-2510
Phone (516) 829-6931
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: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2018 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R017580 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326412800000",
"number": "1215953120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 SHADOW LN",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110212510",
"telephone_number": "516-829-6931",
"fax_number": "516-466-6541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 SHADOW LN",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110212510",
"telephone_number": "516-829-6931",
"fax_number": "516-466-6541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARDAVID",
"first_name": "HERBERT",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2012-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R017580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.