Individual provider Active NPI

Mark M Zimmermann, LCSW-R

  • Addiction (Substance Use Disorder) Counselor
  • Bethesda, MD
National Provider Identifier
1275782179
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
081485 Issued in NY
Practice address
4710 Elm St Apt W1304
Bethesda, MD 20814-3828
Phone
(917) 830-3463
Fax
(347) 717-7750
NPI assigned
Sep 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R081485 NY
Clinical Social Worker 1041C0700X 081485 NY
Clinical Social Worker 1041C0700X 32135 MD
Clinical Social Worker 1041C0700X LC200003450 DC
Addiction (Substance Use Disorder) Counselor 101YA0400X 081485 NY Primary

Addresses

Primary practice location

4710 Elm St Apt W1304
Bethesda, MD 20814-3828

Mailing address

4710 Elm St Apt W1304
Bethesda, MD 20814-3828
Phone (917) 830-3463

Other identifiers 3

IdentifierTypeStateIssuer
100492058MedicaidMD
1386005213OtherNYNPI
03366314MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140822000715 NY Practitioner - Clinical Social Worker 9638397300 Reassigns benefits to 1 organization
I20241231000585 DC Practitioner - Clinical Social Worker 9638397300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
East Point Medical PCGroup PAC ID 0749690741, 24 clinicians

Practice addresses (Care Compare)

7116 Grand Ave
Maspeth, NY 11378-1823
Phone (718) 307-1577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
081485NYMDAddiction (Substance Use Disorder) Counselor
32135MDMDClinical Social Worker
R081485NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
East Point Medical PC Clinical CurrentSince Nov 1, 2021 Accepting new patients
Good Health Psychiatric Services PC Past Accepting new patients

Locations

7116 Grand Ave
Maspeth, NY 11378
Phone (718) 307-1577

Networks

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

Organizations & group practices 3

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": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1275782179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 ELM ST APT W1304",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143828",
            "telephone_number": "917-830-3463",
            "fax_number": "347-717-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 ELM ST APT W1304",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143828",
            "telephone_number": "917-830-3463",
            "fax_number": "347-717-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMANN",
        "first_name": "MARK",
        "middle_name": "M",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-16",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R081485",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081485",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "32135",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200003450",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "081485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100492058",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1386005213",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03366314",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.