Ayelet Pelman Goldberg, LCSW, MFT

Primary specialty

Social WorkerTaxonomy code 104100000X

License

081948-1 Issued in NY

Practice address

6143 186TH St Ste 312
Fresh Meadows, NY 11365-2710

Phone

(917) 923-7644

NPI assigned

Apr 13, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Union Plaza Nursing Home Inc

  • Skilled Nursing Facility
  • Flushing, NY
  • NPI 1366424350
  NPD (past)

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1407146285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6143 186TH ST STE 312",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652710",
            "telephone_number": "917-923-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6143 186TH ST STE 312",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652710",
            "telephone_number": "917-923-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "AYELET",
        "middle_name": "PELMAN",
        "name_prefix": "Mrs.",
        "credential": "LCSW, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-13",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "081948-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Gibbs Jr., M.D.
• Jonathan Glickman
• Tanya Gnanaraj, R.N.
• Theodore Alexander Goetz, OTR/L
• Carly Goga, PA-C
• Valerie Goldburt, MD
• Noa Goldman, MS CCC-SLP
• Andrea Maria Goldson, LCSW-R
• Marissa Goldstein
• Juanpaulo Emiro Gomez Gutierrez, LMT

• Social Worker in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.