Active NPI
Keith E Dorgan, LMSW
- Social Worker
- New York, NY
National Provider Identifier
1447738018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 103295
- Practice address
- 215 West 125TH Street
2ND Floor
New York, NY 10027-4426 - Phone
- (212) 491-2400
- Fax
- (212) 491-2401
- NPI assigned
- Aug 5, 2018
- Sex
- Male
- Sole proprietor
- No
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 | 103295 | NY | Primary |
Addresses
Primary practice location
215 West 125TH Street
2ND Floor
New York, NY 10027-4426
Mailing address
55 Water Street
2ND Floor Cred Dept
New York, NY 10041-0004
Phone (646) 680-2888
Other practice location 1
4337 Broadway
New York, NY 10033-2411
Phone (212) 568-6300
Other practice location 2
590 Fifth Avenue
New York, NY 10036-4702
Phone (212) 582-7117
Other practice location 3
154 West 71st Street
New York, NY 10023-4005
Phone (212) 496-4600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174557409 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103295 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568160000000",
"number": "1447738018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 WATER STREET",
"address_2": "2ND FLOOR CRED DEPT",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100410004",
"telephone_number": "646-680-2888",
"fax_number": "516-542-5556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 WEST 125TH STREET",
"address_2": "2ND FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100274426",
"telephone_number": "212-491-2400",
"fax_number": "212-491-2401"
}
],
"practiceLocations": [
{
"address_1": "4337 Broadway",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100332411",
"country_code": "US",
"telephone_number": "212-568-6300",
"fax_number": "212-544-5094",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "590 Fifth Avenue",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100364702",
"country_code": "US",
"telephone_number": "212-582-7117",
"fax_number": "212-484-3530",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "154 West 71st Street",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100234005",
"country_code": "US",
"telephone_number": "212-496-4600",
"fax_number": "917-441-0195",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DORGAN",
"first_name": "KEITH",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-05",
"last_updated": "2019-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "103295",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1174557409",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.