Individual provider Active NPI

Kimberly J Marganski, LCSW

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1407208358
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007676 Issued in CT
Practice address
123 York St Apt 1D
New Haven, CT 06511-5660
Phone
(203) 525-4275
NPI assigned
Jul 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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 007676 CT Primary

Addresses

Primary practice location

123 York St Apt 1D
New Haven, CT 06511-5660

Mailing address

123 York St Apt 1D
New Haven, CT 06511-5660
Phone (203) 525-4275

Other identifiers 1

IdentifierTypeStateIssuer
1407208358MedicaidCT

Other names 1

  • Mrs. Kimberly J Marganski Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20170517002012 CT Practitioner - Clinical Social Worker 7719254077 Reassigns benefits to 1 organization
Practice locations: New Haven, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7676CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Feb 8, 2019 Accepting new patients
Yale University CurrentSince Feb 8, 2019 Accepting new patients
Kimberly Gereda Psychotherapy & Self-Care Clinical PastSince Jul 29, 2016 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1407208358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 YORK ST APT 1D",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115660",
            "telephone_number": "203-525-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 YORK ST APT 1D",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115660",
            "telephone_number": "203-525-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARGANSKI",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-04",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407208358",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MARGANSKI",
            "middle_name": "J",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.