Individual provider Active NPI

Maya Trifonov, SOCIAL WORKER

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1528123205
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R047562-1 Issued in NY
Practice address
1350 Bay Ridge Pkwy
Brooklyn, NY 11228-2211
Phone
(718) 232-2657
NPI assigned
Dec 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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
Clinical Social Worker 1041C0700X R047562-1 NY Primary

Addresses

Primary practice location

1350 Bay Ridge Pkwy
Brooklyn, NY 11228-2211

Mailing address

1350 Bay Ridge Pkwy
Brooklyn, NY 11228-2211
Phone (718) 232-2657

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
I20101028000263 NY Practitioner - Clinical Social Worker 1355535907 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1350 Bay Ridge Pkwy
Brooklyn, NY 11228-2211
Phone (718) 232-2657

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R047562-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1166918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528123205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 BAY RIDGE PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282211",
            "telephone_number": "718-232-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BAY RIDGE PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282211",
            "telephone_number": "718-232-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIFONOV",
        "first_name": "MAYA",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R047562-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.