Individual provider Active NPI

Michelle Dos Santos

  • Social Worker
  • Jamaica, NY
National Provider Identifier
1255715439
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
092311-1 Issued in NY
Practice address
16110 Jamaica Ave Lbby 2
Jamaica, NY 11432-6137
Phone
(718) 704-5488
NPI assigned
Jul 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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 092311-1 NY Primary

Addresses

Primary practice location

16110 Jamaica Ave Lbby 2
Jamaica, NY 11432-6137

Mailing address

16110 Jamaica Ave Lbby 2
Jamaica, NY 11432-6137
Phone (718) 704-5488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
092311-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Coordinated Behavioral Care Ipa Inc Past 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": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1255715439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16110 JAMAICA AVE LBBY 2",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114326137",
            "telephone_number": "718-704-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16110 JAMAICA AVE LBBY 2",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114326137",
            "telephone_number": "718-704-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOS SANTOS",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "092311-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.