Active NPI
Carlos San Inocencio
- Clinical Social Worker
- West Palm Beach, FL
National Provider Identifier
1306347117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 900 54TH St
West Palm Beach, FL 33407-2436 - Phone
- (772) 617-1717
- NPI assigned
- Feb 27, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
900 54TH St
West Palm Beach, FL 33407-2436
Mailing address
4001 Maple Ave Ste 600
Dallas, TX 75219-3241
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 5, 2024 through Mar 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519689600000",
"number": "1306347117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 MAPLE AVE STE 600",
"city": "DALLAS",
"state": "TX",
"postal_code": "752193241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 54TH ST",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334072436",
"telephone_number": "772-617-1717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAN INOCENCIO",
"first_name": "CARLOS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-27",
"last_updated": "2018-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.