Individual provider Active NPI

Josephine R Feldman

  • Clinical Social Worker
  • Port Washington, NY
National Provider Identifier
1508213356
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R052583-1 Issued in NY
Practice address
77 Country Club Dr
Port Washington, NY 11050-4535
Phone
(917) 842-0876
NPI assigned
May 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2016

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 R052583-1 NY Primary

Addresses

Primary practice location

77 Country Club Dr
Port Washington, NY 11050-4535

Mailing address

77 Country Club Dr
Port Washington, NY 11050-4535
Phone (917) 842-0876

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

LicenseStateTypeSpecialty
R052583-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1508213356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 COUNTRY CLUB DR",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110504535",
            "telephone_number": "917-842-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 COUNTRY CLUB DR",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110504535",
            "telephone_number": "917-842-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDMAN",
        "first_name": "JOSEPHINE",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R052583-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.