Individual provider Active NPI

John Edward Dzwonar, LMSW

  • Social Worker
  • New York, NY
National Provider Identifier
1619142965
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
72076206 Issued in NY
Practice address
400 West 43Rd Street
Apt 35B
New York, NY 10036-6301
Phone
(212) 564-4961
NPI assigned
Apr 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 72076206 NY Primary

Addresses

Primary practice location

400 West 43Rd Street
Apt 35B
New York, NY 10036-6301

Mailing address

400 West 43Rd Street
Apt 35B
New York, NY 10036-6301
Phone (212) 564-4961

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
I20131226000042 NY Practitioner - Clinical Social Worker 9436386265 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 W 43Rd St
New York, NY 10036-6346
Phone (917) 282-7603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
72076206NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1619142965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WEST 43RD STREET",
            "address_2": "APT 35B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100366301",
            "telephone_number": "212-564-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WEST 43RD STREET",
            "address_2": "APT 35B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100366301",
            "telephone_number": "212-564-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZWONAR",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "72076206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.