Individual provider Active NPI

Grace Padilla-Matthew, LMSW

  • Social Worker
  • New York, NY
National Provider Identifier
1477756559
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
068088-1 Issued in NY
Practice address
317 E 64TH St
New York, NY 10021-6704
Phone
(212) 535-5221
Fax
(212) 535-7699
NPI assigned
Jun 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 068088-1 NY Primary

Addresses

Primary practice location

317 E 64TH St
New York, NY 10021-6704

Mailing address

2920 Bouck Ave
Bronx, NY 10469-5211
Phone (212) 535-5221

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
I20130228000096 NY Practitioner - Clinical Social Worker 7719132505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
068088-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Nov 4, 2012 Accepting new patients
Montefiore Medical Center CurrentSince Nov 4, 2012 Accepting new patients

Locations

853 Longwood Ave
Bronx, NY 10459
Phone (718) 588-4460

111 E 210th St
Bronx, NY 10467

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477756559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 BOUCK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695211",
            "telephone_number": "212-535-5221",
            "fax_number": "212-535-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 E 64TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100216704",
            "telephone_number": "212-535-5221",
            "fax_number": "212-535-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADILLA-MATTHEW",
        "first_name": "GRACE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "068088-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.