Individual provider Active NPI

Peter J Jurmann

  • Clinical Social Worker
  • Amityville, NY
National Provider Identifier
1275630170
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R056783-1 Issued in NY
Practice address
5 Dowsing PL
Amityville, NY 11701-3719
Phone
(631) 598-0147
Fax
(631) 598-4823
NPI assigned
Sep 20, 2006
Last updated
Nov 1, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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 R056783-1 NY Primary

Addresses

Primary practice location

5 Dowsing PL
Amityville, NY 11701-3719

Mailing address

5 Dowsing PL
Amityville, NY 11701-3719
Phone (631) 598-0147

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
I20110110000841 NY Practitioner - Clinical Social Worker 7416146238 Practice locations: Amityville, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5 Dowsing PL
Amityville, NY 11701-3719

5 Dowsing Place
Amityville, NY 11701-3719
Phone (631) 598-0147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R056783-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ilene Jurmann, PH.D., Psychologist, P.C. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1275630170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DOWSING PL",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117013719",
            "telephone_number": "631-598-0147",
            "fax_number": "631-598-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DOWSING PL",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117013719",
            "telephone_number": "631-598-0147",
            "fax_number": "631-598-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURMANN",
        "first_name": "PETER",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R056783-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

Verify at the official NPI Registry.