Individual provider Active NPI

Bonnie Eaker Weil

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1578835989
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R016443 Issued in NY
Practice address
30 Waterside PLZ
Apt 12J
New York, NY 10010-2622
Phone
(212) 685-9236
NPI assigned
Jan 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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 R016443 NY Primary

Addresses

Primary practice location

30 Waterside PLZ
Apt 12J
New York, NY 10010-2622

Mailing address

30 Waterside PLZ
Apt 12J
New York, NY 10010-2622
Phone (212) 685-9236

Other identifiers 1

IdentifierTypeStateIssuer
R016443OtherNYLICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 24, 2017 through Jul 24, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R016443NYMDClinical Social Worker
016443NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1578835989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WATERSIDE PLZ",
            "address_2": "APT 12J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102622",
            "telephone_number": "212-685-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WATERSIDE PLZ",
            "address_2": "APT 12J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102622",
            "telephone_number": "212-685-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAKER WEIL",
        "first_name": "BONNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-31",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R016443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "R016443",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.