Individual provider Active NPI

Jamie Almodovar

  • Clinical Social Worker
  • Bridgeport, CT
National Provider Identifier
1598033045
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006885 Issued in CT
Practice address
60 Housatonic Ave
Bridgeport, CT 06604-4026
Phone
(203) 579-6588
NPI assigned
Dec 12, 2011
Last updated
Jul 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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 006885 CT Primary

Addresses

Primary practice location

60 Housatonic Ave
Bridgeport, CT 06604-4026

Mailing address

59 Ridgeview Ave
Trumbull, CT 06611-1936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20200219002625 CT Practitioner - Clinical Social Worker 2163859737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Coastal Connecticut Counseling LLCGroup PAC ID 8527361161, 9 clinicians

Practice addresses (Care Compare)

2960 Post Rd
Suite 3B2
Southport, CT 06890-1268
Phone (203) 307-3030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006885CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Connecticut Counseling LLC CurrentSince Jan 10, 2020 Accepting new patients

Locations

1 Eliot Pl
#3C
Fairfield, CT 06824

1 Eliot Pl
Ste 3
Fairfield, CT 06824

2960 Post Rd
Ste 3B2
Southport, CT 06890
Phone (203) 307-3030

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1598033045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 RIDGEVIEW AVE",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066111936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HOUSATONIC AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066044026",
            "telephone_number": "203-579-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALMODOVAR",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-12",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.