Individual provider Active NPI

Kuburat Ibikunle, LMSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1427520246
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105687 Issued in NY
Practice address
169 W 133Rd St
New York, NY 10030-3301
Phone
(646) 762-4950
Fax
(646) 762-4955
NPI assigned
Dec 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 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 105687 NY Primary

Addresses

Primary practice location

169 W 133Rd St
New York, NY 10030-3301

Mailing address

306 Lenox Ave FL 3
New York, NY 10027-4465
Phone (212) 803-2850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
105687NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Shlomit Levy Past Accepting new patients
Upper Room AIDS Ministry, Inc. Adult Day Health Care Center. Clinical PastSince Jan 4, 2016 Accepting new patients

Organizations & group practices 2

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": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1427520246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 LENOX AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274465",
            "telephone_number": "212-803-2850",
            "fax_number": "212-803-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 W 133RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100303301",
            "telephone_number": "646-762-4950",
            "fax_number": "646-762-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBIKUNLE",
        "first_name": "KUBURAT",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-18",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "105687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.