Individual provider Active NPI

Joseph Perales, LCSW

  • Clinical Social Worker
  • Newburgh, NY
National Provider Identifier
1396923876
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R072103 Issued in NY
Practice address
141 Broadway
Newburgh, NY 12550-6204
Phone
(845) 568-5260
Fax
(845) 568-5213
NPI assigned
Feb 6, 2008
Last updated
Apr 2, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R072103 NY Primary

Addresses

Primary practice location

141 Broadway
Newburgh, NY 12550-6204

Mailing address

30 Harriman Dr
Goshen, NY 10924
Phone (845) 291-2143

Other practice location 1

146 Pike St
Port Jervis, NY 12771-1808
Phone (845) 858-1456

Other practice location 2

60 Erie St Ste 403
Goshen, NY 10924-1531
Phone (845) 551-3077

Other identifiers 1

IdentifierTypeStateIssuer
02973522MedicaidNY

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
I20080414000590 NY Practitioner - Clinical Social Worker 2860579935 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R072103NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Orange CurrentSince Dec 3, 2007 Accepting new patients
County of Orange CurrentSince Dec 3, 2007 Accepting new patients
County of Orange Current Accepting new patients

Locations

30 Harriman Dr
Goshen, NY 10924
Phone (845) 291-2600

141 Broadway
Newburgh, NY 12550
Phone (845) 568-5260

146 Pike St
Port Jervis, NY 12771
Phone (845) 856-1458

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1396923876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HARRIMAN DR",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "10924",
            "telephone_number": "845-291-2143",
            "fax_number": "845-291-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 BROADWAY",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125506204",
            "telephone_number": "845-568-5260",
            "fax_number": "845-568-5213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "146 Pike St",
            "address_purpose": "LOCATION",
            "city": "Port Jervis",
            "state": "NY",
            "postal_code": "127711808",
            "country_code": "US",
            "telephone_number": "845-858-1456",
            "fax_number": "845-858-1459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "60 Erie St Ste 403",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "NY",
            "postal_code": "109241531",
            "country_code": "US",
            "telephone_number": "845-551-3077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERALES",
        "first_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R072103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02973522",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.