Active NPI
Jacqueline Padilla, LCSW
- Social Worker
- Eastchester, NY
National Provider Identifier
1336368281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- R025120
- Practice address
- 479 White Plains Rd
Eastchester, NY 10709-5516 - Phone
- (914) 793-9787
- Fax
- (914) 776-2461
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | R025120 | NY | Primary |
Addresses
Primary practice location
479 White Plains Rd
Eastchester, NY 10709-5516
Mailing address
12 Bronxville Glen Dr
Apt. 12
Bronxville, NY 10708-6828
Phone (917) 793-9787
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Nov 16, 2017 through Nov 16, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R025120 | NY | MD | Social Worker |
| 025120 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336368281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 BRONXVILLE GLEN DR",
"address_2": "APT. 12",
"city": "BRONXVILLE",
"state": "NY",
"postal_code": "107086828",
"telephone_number": "917-793-9787",
"fax_number": "914-776-2461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "479 WHITE PLAINS RD",
"city": "EASTCHESTER",
"state": "NY",
"postal_code": "107095516",
"telephone_number": "914-793-9787",
"fax_number": "914-776-2461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PADILLA",
"first_name": "JACQUELINE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "R025120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eastchester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.