Individual provider Active NPI

Bia Kinsbrunner Roth, LCSW

  • Clinical Social Worker
  • Emerson, NJ
National Provider Identifier
1346308111
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00033200 Issued in NJ
Practice address
99 Kinderkamack Rd
Emerson, NJ 07630-1870
Phone
(201) 265-2033
Fax
(201) 265-8272
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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 44SC00033200 NJ Primary
Clinical Social Worker 1041C0700X PR004324-1 NY

Addresses

Primary practice location

99 Kinderkamack Rd
Emerson, NJ 07630-1870

Mailing address

99 Kinderkamack Rd
Emerson, NJ 07630-1870
Phone (201) 265-2033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050412001246 NJ Practitioner - Clinical Social Worker 4880631787 Practice locations: Paramus, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

226 Homestead Rd
Paramus, NJ 07652-4710
Phone (201) 265-2033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR004324-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Adult Resource Center Clinical Past Accepting new patients
Ankle & Foot Health & Trauma Institute PA Past Accepting new patients

Organizations & group practices 2

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1346308111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 KINDERKAMACK RD",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301870",
            "telephone_number": "201-265-2033",
            "fax_number": "201-265-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 KINDERKAMACK RD",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301870",
            "telephone_number": "201-265-2033",
            "fax_number": "201-265-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "BIA",
        "middle_name": "KINSBRUNNER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00033200",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR004324-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emerson, NJ

Sources for this page

Verify at the official NPI Registry.