Active NPI
Roldophe A Dormeus
- Clinical Social Worker
- Jamaica, NY
National Provider Identifier
1487806287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 070213-1
- Practice address
- 16832 127TH Ave
11D
Jamaica, NY 11434-3156 - Phone
- (347) 287-1191
- NPI assigned
- Oct 13, 2008
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 070213-1 | NY | Primary |
Addresses
Primary practice location
16832 127TH Ave
11D
Jamaica, NY 11434-3156
Mailing address
16832 127TH Ave
11D
Jamaica, NY 11434-3156
Phone (347) 287-1191
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070213-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223856000000",
"number": "1487806287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16832 127TH AVE",
"address_2": "11D",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114343156",
"telephone_number": "347-287-1191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16832 127TH AVE",
"address_2": "11D",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114343156",
"telephone_number": "347-287-1191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORMEUS",
"first_name": "ROLDOPHE",
"middle_name": "A",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-13",
"last_updated": "2008-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "070213-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.