Individual provider Active NPI

Jacob Ian Margolis

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1558029629
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
101325 Issued in NY
Practice address
170 Brown PL
Bronx, NY 10454-4140
Phone
(860) 849-9317
NPI assigned
Dec 6, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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 101325 NY Primary

Addresses

Primary practice location

170 Brown PL
Bronx, NY 10454-4140

Mailing address

590 Avenue of Americas
New York, NY 10011-9904
Phone (860) 849-9317

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

LicenseStateTypeSpecialty
101325NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1558029629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 AVENUE OF AMERICAS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100119904",
            "telephone_number": "860-849-9317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 BROWN PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104544140",
            "telephone_number": "860-849-9317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARGOLIS",
        "first_name": "JACOB",
        "middle_name": "IAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-06",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "101325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.