Individual provider Active NPI

Ami Burgos

  • Social Worker
  • Fair Lawn, NJ
National Provider Identifier
1518649946
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SL06726100 Issued in NJ
Practice address
16-01 Broadway
Fair Lawn, NJ 07410-2026
Phone
(201) 797-0001
NPI assigned
Aug 4, 2023
Last updated
Aug 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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 44SL06726100 NJ Primary

Addresses

Primary practice location

16-01 Broadway
Fair Lawn, NJ 07410-2026

Mailing address

16-01 Broadway
Fair Lawn, NJ 07410-2026

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL06726100NJMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1691107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1518649946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16-01 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16-01 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102026",
            "telephone_number": "201-797-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS",
        "first_name": "AMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-04",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06726100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.