Active NPI
Gisell M Perez Ortiz, LMSW
- Social Worker
- Far Rockaway, NY
National Provider Identifier
1437606308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 098154-1
- Practice address
- 521 Beach 20TH St
Far Rockaway, NY 11691-3645 - Phone
- (718) 869-8822
- NPI assigned
- Sep 8, 2016
- Last updated
- Mar 9, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 098154-1 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Long Island Consultation Center, Inc. | Current | Accepting new patients | |
| Long Island Consultation Center | Current | Accepting new patients |
Locations
9131 Queens Blvd
Ste 222
Elmhurst, NY 11373
Phone (718) 896-3400
Interoperability endpoints
- 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.
-
- Clinical Social Worker
- Elmhurst, NY
- NPI 1295878577
-
- Counselor
- Elmhurst, NY
- NPI 1356016703
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.