Individual provider Active NPI

Daniel J Ayres, LCSW

  • Clinical Social Worker
  • Johnstown, PA
National Provider Identifier
1437593142
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW018066 Issued in PA
Practice address
1190 Florida Ave
Johnstown, PA 15902-3905
Phone
(814) 242-0692
NPI assigned
Apr 24, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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 CW018066 PA Primary

Addresses

Primary practice location

1190 Florida Ave
Johnstown, PA 15902-3905

Mailing address

1190 Florida Ave
Johnstown, PA 15902-3905
Phone (814) 242-0692

Other identifiers 1

IdentifierTypeStateIssuer
1029736250001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150127000170 PA Practitioner - Clinical Social Worker 0749504587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nulton Diagnostic and Treatment Center, PCGroup PAC ID 5294621363, 38 clinicians

Practice addresses (Care Compare)

214 College Park PLZ
Johnstown, PA 15904-2833
Phone (814) 262-0025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW018066PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nulton Diagnostic & Treatment Center, PC CurrentSince Dec 1, 2014 Accepting new patients
Nulton Diagnostic & Treatment Center, PC. CurrentSince Dec 1, 2014 Accepting new patients

Locations

214 College Park Plz
Johnstown, PA 15904
Phone (814) 262-0025

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": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1437593142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 FLORIDA AVE",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159023905",
            "telephone_number": "814-242-0692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 FLORIDA AVE",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159023905",
            "telephone_number": "814-242-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYRES",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-24",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029736250001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.