Individual provider Active NPI

Pauline Sharon Wieand, L.C.S.W.

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1457451056
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
086298 Issued in NY
Practice address
134 N 4TH St
Brooklyn, NY 11249-3296
Phone
(646) 450-7748
Fax
(718) 481-2061
NPI assigned
Sep 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 089.0135184 VT
Clinical Social Worker 1041C0700X SW8166 FL
Clinical Social Worker 1041C0700X 086298 NY Primary

Addresses

Primary practice location

134 N 4TH St
Brooklyn, NY 11249-3296

Mailing address

134 N 4TH St
Brooklyn, NY 11249-3296
Phone (646) 450-7748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190213003117 NY Practitioner - Clinical Social Worker 6103103312 Reassigns benefits to 2 organizations
I20230420001498 VT Practitioner - Clinical Social Worker 6103103312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Buffalo School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valera Medical PCGroup PAC ID 0547690521, 160 clinicians

Practice addresses (Care Compare)

134 N 4TH St
Brooklyn, NY 11249-3296
Phone (646) 450-7748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
086298NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Valera Medical, P.a. Clinical CurrentSince Apr 3, 2023 Accepting new patients
Valera Medical, P.C. Clinical CurrentSince Jan 11, 2022 Accepting new patients
Rochester Rehabilitation Center, Inc CurrentSince Jan 27, 2020 Accepting new patients
Rochester Rehabilitation Center PastSince Jan 27, 2020 Accepting new patients

Locations

134 N 4th St
Brooklyn, NY 11249

139 Centre St
Ste 824
New York, NY 10013
Phone (646) 450-7751

1100 Elmwood Ave
Rochester, NY 14620
Phone (585) 271-0680

1000 Elmwood Ave
Ste 600
Rochester, NY 14620
Phone (585) 471-0559

1 Lawson Ln
Ste 200D
Burlington, VT 05401
Phone (802) 236-6742

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/7c4ed6b7-c140-41eb-bc5a-5ee81640f80d/

Organizations & group practices 4

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": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1457451056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 N 4TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112493296",
            "telephone_number": "646-450-7748",
            "fax_number": "718-481-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 N 4TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112493296",
            "telephone_number": "646-450-7748",
            "fax_number": "718-481-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEAND",
        "first_name": "PAULINE",
        "middle_name": "SHARON",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-23",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0135184",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8166",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.