Active NPI
Alexa Rachelle Mediak, LMSW
- Social Worker
- New York, NY
National Provider Identifier
1336867522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 115250
- Practice address
- 175 E 94TH St Apt 1
New York, NY 10128-2905 - Phone
- (917) 674-3421
- NPI assigned
- Aug 15, 2022
- Last updated
- Aug 15, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 115250 | NY | Primary |
Addresses
Primary practice location
175 E 94TH St Apt 1
New York, NY 10128-2905
Mailing address
88 Pleasant View Dr
Lancaster, NY 14086-1002
Phone (716) 861-0361
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115250 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660521600000",
"number": "1336867522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 PLEASANT VIEW DR",
"city": "LANCASTER",
"state": "NY",
"postal_code": "140861002",
"telephone_number": "716-861-0361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 E 94TH ST APT 1",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101282905",
"telephone_number": "917-674-3421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDIAK",
"first_name": "ALEXA",
"middle_name": "RACHELLE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-15",
"last_updated": "2022-08-15",
"certification_date": "2022-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "115250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.