Individual provider Active NPI

Jeffrey Stanley Soffer, LCSW

  • Clinical Social Worker
  • Middletown, NJ
National Provider Identifier
1417014416
Registry record updated Dec 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC 08388 Issued in NJ
Practice address
407 April Way
Middletown, NJ 07748-6510
Phone
(201) 894-8318
Fax
(201) 871-4775
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2023

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 SC 08388 NJ Primary

Addresses

Primary practice location

407 April Way
Middletown, NJ 07748-6510

Mailing address

407 April Way
Middletown, NJ 07748-6510
Phone (201) 894-8318

Other identifiers 4

IdentifierTypeStateIssuer
SC 08388OtherNJNJ LICENSE
P536670OtherNJOXFORD INS PROVIDER #
R 014757OtherNYLCSW NEW YORK LICENSE
221726712OtherNJGROUP PRACTICE TAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050406000435 NJ Practitioner - Clinical Social Worker 0042267569 Practice locations: Middletown, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

407 April Way
Middletown, NJ 07748-6510
Phone (201) 894-8318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC 08388NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Irby Spine Care PC PastSince Feb 23, 2011 Accepting new patients

Organizations & group practices 1

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702771200000",
    "number": "1417014416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 APRIL WAY",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077486510",
            "telephone_number": "201-894-8318",
            "fax_number": "201-871-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 APRIL WAY",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077486510",
            "telephone_number": "201-894-8318",
            "fax_number": "201-871-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOFFER",
        "first_name": "JEFFREY",
        "middle_name": "STANLEY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2023-12-17",
        "certification_date": "2023-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SC 08388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ LICENSE",
            "identifier": "SC 08388",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD INS PROVIDER #",
            "identifier": "P536670",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW NEW YORK LICENSE",
            "identifier": "R 014757",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PRACTICE TAX ID",
            "identifier": "221726712",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NJ

Sources for this page

Verify at the official NPI Registry.