Individual provider Active NPI

Gisell M Perez Ortiz, LMSW

  • Social Worker
  • Far Rockaway, NY
National Provider Identifier
1437606308
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
098154-1 Issued in NY
Practice address
521 Beach 20TH St
Far Rockaway, NY 11691-3645
Phone
(718) 869-8822
NPI assigned
Sep 8, 2016
Last updated
Mar 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 098154-1 NY Primary

Addresses

Primary practice location

521 Beach 20TH St
Far Rockaway, NY 11691-3645

Mailing address

2115 Haviland Ave
Bronx, NY 10472-5207
Phone (646) 409-6727

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
I20240305001223 NY Practitioner - Clinical Social Worker 2365887981 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
098154-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Consultation Center, Inc. CurrentSince Jan 8, 2024 Accepting new patients
Long Island Consultation Center CurrentSince Jan 8, 2024 Accepting new patients

Locations

9131 Queens Blvd
Ste 222
Elmhurst, NY 11373
Phone (718) 896-3400

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1437606308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 HAVILAND AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104725207",
            "telephone_number": "646-409-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913645",
            "telephone_number": "718-869-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ ORTIZ",
        "first_name": "GISELL",
        "middle_name": "M",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "098154-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.