Individual provider Active NPI

Jacob Salamon

  • Social Worker
  • Monsey, NY
National Provider Identifier
1356980411
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
20 Robert Pitt Dr
Monsey, NY 10952-3330
Phone
(845) 352-6800
NPI assigned
Jan 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NY Primary

Addresses

Primary practice location

20 Robert Pitt Dr
Monsey, NY 10952-3330

Mailing address

25 Mangin Rd
Monroe, NY 10950-2202
Phone (845) 782-2386

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EHR

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
I20240725000631 NY Practitioner - Clinical Social Worker 9032655121 Reassigns benefits to 2 organizations
Practice locations: Spring Valley, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

74 W Eckerson Rd
Spring Valley, NY 10977-3610
Phone (917) 426-1477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Derech Shalom Center Inc CurrentSince Aug 30, 2025 Accepting new patients
Community Assistance Resources & Extended Services Inc CurrentSince Jul 15, 2024 Accepting new patients

Locations

465 Grand St
New York, NY 10002
Phone (212) 420-1970

75 Montebello Rd
Suffern, NY 10901
Phone (845) 523-9300

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": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1356980411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MANGIN RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109502202",
            "telephone_number": "845-782-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ROBERT PITT DR",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109523330",
            "telephone_number": "845-352-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAMON",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "address_1": "20 Robert Pitt Dr",
            "city": "Monsey",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109523330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monsey, NY

Sources for this page

Verify at the official NPI Registry.