Individual provider Active NPI

Rachel Eliana Fraade, LCSW

  • Clinical Social Worker
  • Long Island City, NY
National Provider Identifier
1487429569
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
096531 Issued in NY
Practice address
2976 Northern Blvd
Long Island City, NY 11101-2822
Phone
(718) 906-9479
Fax
(718) 906-9491
NPI assigned
Nov 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 096531 NY Primary

Addresses

Primary practice location

2976 Northern Blvd
Long Island City, NY 11101-2822

Mailing address

2976 Northern Blvd
Long Island City, NY 11101-2822
Phone (718) 906-9479

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
I20240229001280 NY Practitioner - Clinical Social Worker 9335584309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Fortune Society IncGroup PAC ID 0042479263, 5 clinicians

Practice addresses (Care Compare)

2976 Northern Blvd
FL 2
Long Island City, NY 11101-2829
Phone (212) 691-7554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
096531NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Fortune Society CurrentSince Nov 26, 2023 Accepting new patients
The Fortune Society Inc. Clinical CurrentSince Dec 31, 2023 Accepting new patients

Locations

2976 Northern Blvd
Long Island City, NY 11101
Phone (212) 691-7554

2976 Northern Blvd
Fl 2
Long Island City, NY 11101
Phone (212) 691-7554

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": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1487429569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2976 NORTHERN BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012822",
            "telephone_number": "718-906-9479",
            "fax_number": "718-906-9491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2976 NORTHERN BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012822",
            "telephone_number": "718-906-9479",
            "fax_number": "718-906-9491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAADE",
        "first_name": "RACHEL",
        "middle_name": "ELIANA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.