Individual provider Active NPI

Jane Hogan, LCSW, PH.D

  • Clinical Social Worker
  • Floral Park, NY
National Provider Identifier
1528483286
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081424-1 Issued in NY
Practice address
20 S Tyson Ave
Floral Park, NY 11001-2017
Phone
(917) 558-0291
NPI assigned
Mar 4, 2014
Last updated
May 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 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 081424-1 NY Primary

Addresses

Primary practice location

20 S Tyson Ave
Floral Park, NY 11001-2017

Mailing address

975 Tarpon Cove Dr Apt 202
Naples, FL 34110-3611
Phone (917) 558-0291

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
I20180823001763 NY Practitioner - Clinical Social Worker 6002165024 Practice locations: Floral Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

20 S Tyson Ave
Floral Park, NY 11001-2017
Phone (917) 558-0291

9 Northfield Rd
Glen Cove, NY 11542-1717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
081424-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Romaxter LLC Current Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1528483286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 TARPON COVE DR APT 202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341103611",
            "telephone_number": "917-558-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S TYSON AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110012017",
            "telephone_number": "917-558-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "LCSW, PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-04",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081424-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

Verify at the official NPI Registry.