Individual provider Active NPI

Reshma Rajesh Shah, LCSW

  • Clinical Social Worker
  • Elmhurst, NY
National Provider Identifier
1407993272
Registry record updated Dec 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
073579-1 Issued in NY
Practice address
8708 Justice Ave Ste C7
Elmhurst, NY 11373-4590
Phone
(718) 899-9810
Fax
(718) 899-9699
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2015

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 073579-1 NY Primary

Addresses

Primary practice location

8708 Justice Ave Ste C7
Elmhurst, NY 11373-4590

Mailing address

8111 45TH Ave Apt 6D
Elmhurst, NY 11373-3517
Phone (718) 205-0463

Other identifiers 1

IdentifierTypeStateIssuer
1041C0700XOtherNYSOCIAL WORKER CLINICAL

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
I20160219001262 NY Practitioner - Clinical Social Worker 0446555080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Settlement Society of New YorkGroup PAC ID 4486545662, 7 clinicians

Practice addresses (Care Compare)

184 Eldridge St
New York, NY 10002-2924
Phone (212) 674-9120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073579-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University Settlement Society of New York CurrentSince Sep 1, 2020 Accepting new patients
The Child Center of Ny Past Accepting new patients
Sahaara, Inc. PastSince Feb 23, 2021 Accepting new patients

Locations

184 Eldridge St
New York, NY 10002
Phone (212) 453-4509

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450396800000",
    "number": "1407993272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8111 45TH AVE APT 6D",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733517",
            "telephone_number": "718-205-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8708 JUSTICE AVE STE C7",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734590",
            "telephone_number": "718-899-9810",
            "fax_number": "718-899-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RESHMA",
        "middle_name": "RAJESH",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2015-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073579-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORKER CLINICAL",
            "identifier": "1041C0700X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.