Individual provider Active NPI

Max Bivona, LMSW

  • Social Worker
  • Forest Hills, NY
National Provider Identifier
1528539244
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
103534 Issued in NY
Practice address
10470 Queens Blvd Ste 200
Forest Hills, NY 11375-3694
Phone
(718) 275-6010
NPI assigned
Dec 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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 103534 NY Primary

Addresses

Primary practice location

10470 Queens Blvd Ste 200
Forest Hills, NY 11375-3694

Mailing address

10470 Queens Blvd Ste 200
Forest Hills, NY 11375-3694

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
I20220904000004 NY Practitioner - Clinical Social Worker 3971987298 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bleuler Psychotherapy Center, Inc. CurrentSince May 31, 2022 Accepting new patients

Locations

10470 Queens Blvd
Ste 200
Forest Hills, NY 11375
Phone (866) 404-6913

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/bleulerpc/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1528539244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 QUEENS BLVD STE 200",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10470 QUEENS BLVD STE 200",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753694",
            "telephone_number": "718-275-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIVONA",
        "first_name": "MAX",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "103534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.