Active NPI
Douglas Zimmerman
- Social Worker
- New York, NY
National Provider Identifier
1366641359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 069193-1
- Practice address
- 425 East 58TH Street
Suite 23F
New York, NY 10022-2379 - Phone
- (917) 940-4055
- NPI assigned
- Jul 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 069193-1 | NY | Primary |
Addresses
Primary practice location
425 East 58TH Street
Suite 23F
New York, NY 10022-2379
Mailing address
160 W End Ave
27H
New York, NY 10023-5601
Phone (917) 940-4055
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 069193-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274140800000",
"number": "1366641359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 W END AVE",
"address_2": "27H",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100235601",
"telephone_number": "917-940-4055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 EAST 58TH STREET",
"address_2": "SUITE 23F",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100222379",
"telephone_number": "917-940-4055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "DOUGLAS",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-11",
"last_updated": "2010-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "069193-1",
"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 May 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.