Active NPI
Shelby Jackowitz
- Social Worker
- New York, NY
National Provider Identifier
1528515624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 095657
- Practice address
- 260 Madison Ave
Ste 8051 and Set 8065
New York, NY 10016-2401 - Phone
- (646) 661-3840
- NPI assigned
- Sep 6, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 095657 | NY | Primary |
Addresses
Primary practice location
260 Madison Ave
Ste 8051 and Set 8065
New York, NY 10016-2401
Mailing address
240 E 27TH St
Apt 7a
New York, NY 10016-9277
Phone (862) 955-0109
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 |
|---|---|---|---|
| 095657 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473120000000",
"number": "1528515624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 E 27TH ST",
"address_2": "APT 7A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100169277",
"telephone_number": "862-955-0109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 MADISON AVE",
"address_2": "STE 8051 AND SET 8065",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100162401",
"telephone_number": "646-661-3840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKOWITZ",
"first_name": "SHELBY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-06",
"last_updated": "2016-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "095657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.