Individual provider Active NPI

Alan Z Taub, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1336387950
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079114 Issued in NY
Practice address
2925A Kings Hwy
Brooklyn, NY 11229-1805
Phone
(718) 382-0051
Fax
(718) 382-0051
NPI assigned
Feb 4, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 077639-1 NY
Clinical Social Worker 1041C0700X 079114 NY Primary

Addresses

Primary practice location

2925A Kings Hwy
Brooklyn, NY 11229-1805

Mailing address

2925A Kings Hwy
Brooklyn, NY 11229-1805
Phone (718) 382-0051

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
I20141216002094 NY Practitioner - Clinical Social Worker 0143543595 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077639-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Premium Health Inc CurrentSince May 14, 2014 Accepting new patients

Locations

620 Foster Ave
Ste 200
Brooklyn, NY 11230
Phone (718) 407-7300

620 Foster Ave
Brooklyn, NY 11230

Networks

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

Organizations & group practices 1

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": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1336387950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925A KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291805",
            "telephone_number": "718-382-0051",
            "fax_number": "718-382-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925A KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291805",
            "telephone_number": "718-382-0051",
            "fax_number": "718-382-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUB",
        "first_name": "ALAN",
        "middle_name": "Z",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077639-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.