Individual provider Active NPI

Wanda I Marquez, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1306086533
Registry record updated Feb 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
075249-1 Issued in NY
Practice address
177 Nagle Ave Apt 14B
New York
New York, NY 10034-6024
Phone
(646) 281-2592
NPI assigned
Feb 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2009

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 059454-1 NY
Clinical Social Worker 1041C0700X 075249-1 NY Primary
School Social Worker 1041S0200X 1742682 NY

Addresses

Primary practice location

177 Nagle Ave Apt 14B
New York
New York, NY 10034-6024

Mailing address

52 Glenwood Dr N
Bergenfield, NJ 07621-3346
Phone (646) 281-2592

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
I20090604000669 NY Practitioner - Clinical Social Worker 1759431133 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
059454-1NYMDSocial Worker
075249-1NYMDClinical Social Worker
1742682NYMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Health Plan, Inc. CurrentSince Sep 12, 2011 Accepting new patients
Urban Health Plan, Inc. CurrentSince Sep 12, 2011 Accepting new patients
Visiting Social Work of New York LCSW P C Social Worker Past Accepting new patients

Locations

1515 Southern Blvd
#H
Bronx, NY 10460
Phone (718) 589-1600

1515 Southern Blvd
Bronx, NY 10460
Phone (718) 589-1600

1065 Southern Blvd
Bronx, NY 10459
Phone 71858924404222

Networks

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

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": "1235692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235692800000",
    "number": "1306086533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 GLENWOOD DR N",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076213346",
            "telephone_number": "646-281-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 NAGLE AVE APT 14B",
            "address_2": "NEW YORK",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100346024",
            "telephone_number": "646-281-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "WANDA",
        "middle_name": "I",
        "name_prefix": "Prof.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-27",
        "last_updated": "2009-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "059454-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075249-1",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NY",
            "license": "1742682",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.