Active NPI
Ditmara Tamayo, LCSW
- Clinical Social Worker
- Coral Springs, FL
National Provider Identifier
1447446810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW6705
- Practice address
- 11760 W Sample Rd Ste 101
Coral Springs, FL 33065-3199 - Phone
- (954) 345-5644
- Fax
- (954) 345-5683
- NPI assigned
- Sep 19, 2007
- Last updated
- Jun 27, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | SW6705 | FL | |
| Clinical Social Worker | 1041C0700X | SW6705 | FL | Primary |
Addresses
Primary practice location
11760 W Sample Rd Ste 101
Coral Springs, FL 33065-3199
Mailing address
11760 W Sample Rd Ste 101
Coral Springs, FL 33065-3199
Phone (954) 345-5644
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Parkland, FL 33076
Phone (954) 345-5644
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Networks
- Freedom Health HMO Network
Organizations & group practices 1
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.
-
- Psychologist
- Coral Springs, FL
- NPI 1730124314
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561593600000",
"number": "1447446810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11760 W SAMPLE RD STE 101",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330653199",
"telephone_number": "954-345-5644",
"fax_number": "954-345-5683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11760 W SAMPLE RD STE 101",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330653199",
"telephone_number": "954-345-5644",
"fax_number": "954-345-5683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAMAYO",
"first_name": "DITMARA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-19",
"last_updated": "2019-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "SW6705",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW6705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coral Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.