Individual provider Active NPI

Steven Michael Gruntfest, JD, LCSW

  • Clinical Social Worker
  • Teaneck, NJ
National Provider Identifier
1437207545
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC01276800 Issued in NJ
Practice address
175 Cedar LN
Suite 2
Teaneck, NJ 07666-4315
Phone
(201) 913-1017
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC01276800 NJ Primary
Clinical Social Worker 1041C0700X 071911 NY

Addresses

Primary practice location

175 Cedar LN
Suite 2
Teaneck, NJ 07666-4315

Mailing address

175 Cedar LN
Suite 2
Teaneck, NJ 07666-4315
Phone (201) 913-1017

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
I20040928001040 NJ Practitioner - Clinical Social Worker 1052380805 Practice locations: Ridgewood, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

75 N Maple Ave
Ridgewood, NJ 07450-3261
Phone (201) 913-1017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Juris Doctor

State licenses

LicenseStateTypeSpecialty
071911NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437207545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CEDAR LN",
            "address_2": "SUITE 2",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664315",
            "telephone_number": "201-913-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CEDAR LN",
            "address_2": "SUITE 2",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664315",
            "telephone_number": "201-913-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNTFEST",
        "first_name": "STEVEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "JD, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC01276800",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071911",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.