Active NPI
Edward G Mandelbaum, LCSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1538366547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 045481-1
- Practice address
- 5 Peter Cooper Rd Apt 7G
New York, NY 10010-6630 - Phone
- (917) 992-1621
- NPI assigned
- Jul 2, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 045481-1 | NY | Primary |
Addresses
Primary practice location
5 Peter Cooper Rd Apt 7G
New York, NY 10010-6630
Mailing address
5 Peter Cooper Rd Apt 7G
New York, NY 10010-6630
Phone (917) 992-1621
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120117000617 | NY | Practitioner - Clinical Social Worker | 0244407120 | Practice locations: New York, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5 Peter Cooper Rd
Apt 7G
New York, NY 10010-6630
Phone (917) 992-1621
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045481-1 | NY | MD | Clinical Social Worker |
| 045481 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749513600000",
"number": "1538366547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 PETER COOPER RD APT 7G",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100106630",
"telephone_number": "917-992-1621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 PETER COOPER RD APT 7G",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100106630",
"telephone_number": "917-992-1621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDELBAUM",
"first_name": "EDWARD",
"middle_name": "G",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-02",
"last_updated": "2025-06-10",
"certification_date": "2025-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "045481-1",
"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 Jun 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.