Individual provider Active NPI

Jennifer Baez, LCSW

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1336386143
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
083571 Issued in NY
Practice address
5676 Riverdale Ave
Suite 202
Bronx, NY 10471-2138
Phone
(718) 796-5300
NPI assigned
Jan 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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 083571 NY Primary

Addresses

Primary practice location

5676 Riverdale Ave
Suite 202
Bronx, NY 10471-2138

Mailing address

5676 Riverdale Ave
Bronx, NY 10471-2138
Phone (718) 769-5300

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
I20170320000846 NY Practitioner - Clinical Social Worker 9335424092 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
083571NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Jan 30, 2017 Accepting new patients
Bronxcare Health System CurrentSince Jan 30, 2017 Accepting new patients
Uplift Behavioral Health PC Clinical Past Accepting new patients

Locations

1276 Fulton Ave
Rm 208
Bronx, NY 10456
Phone (718) 901-8918

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

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": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1336386143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5676 RIVERDALE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104712138",
            "telephone_number": "718-769-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5676 RIVERDALE AVE",
            "address_2": "SUITE 202",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104712138",
            "telephone_number": "718-796-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZ",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-15",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.