Individual provider Active NPI

Dawn Blumhagen, LCSW

  • Clinical Social Worker
  • Rego Park, NY
National Provider Identifier
1619087723
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0589081 Issued in NY
Practice address
98120 Queens Blvd
Apt 1C
Rego Park, NY 11374-4357
Phone
(718) 830-0246
Fax
(718) 830-9088
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0589081 NY Primary

Addresses

Primary practice location

98120 Queens Blvd
Apt 1C
Rego Park, NY 11374-4357

Mailing address

98120 Queens Blvd
Apt 1C
Rego Park, NY 11374-4357
Phone (718) 830-0246

Other identifiers 1

IdentifierTypeStateIssuer
P3537090OtherOXFORD

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050126000103 NY Practitioner - Clinical Social Worker 3678523883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Comprehensive Counseling LCSW PLLCGroup PAC ID 3870754427, 46 clinicians

Practice addresses (Care Compare)

3635 Bell Blvd
Suite 203
Bayside, NY 11361-2097
Phone (718) 830-0246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0589081NYMDClinical Social Worker

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619087723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98120 QUEENS BLVD",
            "address_2": "APT 1C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744357",
            "telephone_number": "718-830-0246",
            "fax_number": "718-830-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98120 QUEENS BLVD",
            "address_2": "APT 1C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744357",
            "telephone_number": "718-830-0246",
            "fax_number": "718-830-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMHAGEN",
        "first_name": "DAWN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0589081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3537090",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.