Individual provider Active NPI

Yuanman Zhao

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1265089114
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
094876 Issued in NY
Practice address
777 Seaview Ave
Staten Island, NY 10305-3409
Phone
(718) 667-2569
NPI assigned
Aug 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 107361 NY
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 094876 NY Primary

Addresses

Primary practice location

777 Seaview Ave
Staten Island, NY 10305-3409

Mailing address

777 Seaview Ave
Staten Island, NY 10305-3409
Phone (718) 667-2569

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
I20230413001674 NY Practitioner - Clinical Social Worker 2860867488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Xu Z. Chen Psychiatrist, LLCGroup PAC ID 4385682657, 15 clinicians

Practice addresses (Care Compare)

837 58TH St
FL 3
Brooklyn, NY 11220-3662
Phone (718) 686-1533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107361NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chinese-American Sunshine House Inc Clinical CurrentSince May 1, 2023 Accepting new patients
Xu Z. Chen Psychiatrist, LLC CurrentSince May 1, 2023 Accepting new patients

Locations

6304 5th Ave
Ste 1
Brooklyn, NY 11220
Phone (718) 576-3610

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

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": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1265089114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053409",
            "telephone_number": "718-667-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053409",
            "telephone_number": "718-667-2569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHAO",
        "first_name": "YUANMAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-23",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "107361",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.