Individual provider Active NPI

Jeanne Schwarz

  • Specialist
  • Wantagh, NY
National Provider Identifier
1366525669
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
R030609 Issued in NY
Practice address
1400 Wantagh Ave Ste 208
Wantagh, NY 11793-2210
Phone
(631) 754-2497
Fax
(516) 785-0318
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X R030609 NY Primary

Addresses

Primary practice location

1400 Wantagh Ave Ste 208
Wantagh, NY 11793-2210

Mailing address

1400 Wantagh Ave Ste 208
Wantagh, NY 11793-2210
Phone (631) 754-2497

Other identifiers 1

IdentifierTypeStateIssuer
N21511MedicaidNY

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
I20170413000165 NY Practitioner - Clinical Social Worker 1052697794 Practice locations: Wantagh, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Atlanta School of Medicine, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1400 Wantagh Ave
Suite 208
Wantagh, NY 11793-2210
Phone (631) 897-6794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R030609NYMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1366525669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WANTAGH AVE STE 208",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932210",
            "telephone_number": "631-754-2497",
            "fax_number": "516-785-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WANTAGH AVE STE 208",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932210",
            "telephone_number": "631-754-2497",
            "fax_number": "516-785-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARZ",
        "first_name": "JEANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "R030609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N21511",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

Verify at the official NPI Registry.