Individual provider Active NPI

Bryan I. Proano Redmond, LCSW

  • Clinical Social Worker
  • Summit, NJ
National Provider Identifier
1609339126
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090750 Issued in NY
Practice address
482 Springfield Ave
Summit, NJ 07901-2601
Phone
(908) 273-5558
NPI assigned
Apr 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC06118700 NJ
Clinical Social Worker 1041C0700X 090750 NY Primary

Addresses

Primary practice location

482 Springfield Ave
Summit, NJ 07901-2601

Mailing address

440 Elmwood Ave
Maplewood, NJ 07040-1715
Phone (347) 944-7436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240319001632 NJ Practitioner - Clinical Social Worker 0042669186 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Om Psychological ServicesGroup PAC ID 0446731178, 11 clinicians
Summit Psychological Services PAGroup PAC ID 9032213483, 12 clinicians

Practice addresses (Care Compare)

482 Springfield Ave
FL 2
Summit, NJ 07901-2601
Phone (908) 273-5558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC06118700NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Om Psychological Services CurrentSince Mar 1, 2026 Accepting new patients
Summit Psychological Services PA CurrentSince Mar 1, 2024 Accepting new patients

Locations

482 Springfield Ave
Summit, NJ 07901
Phone (908) 273-5558

482 Springfield Ave
Fl 2
Summit, NJ 07901
Phone (908) 273-5558

Organizations & group practices 2

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": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1609339126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 ELMWOOD AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070401715",
            "telephone_number": "347-944-7436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 SPRINGFIELD AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079012601",
            "telephone_number": "908-273-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROANO REDMOND",
        "first_name": "BRYAN",
        "middle_name": "I.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-11",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06118700",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.