Individual provider Active NPI

Joan P Zimmerman, CSWR

  • Social Worker
  • Brooklyn, NY
National Provider Identifier
1619917648
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
R050967 Issued in NY
Practice address
567 9TH St
Brooklyn, NY 11215-4205
Phone
(718) 398-3839
Fax
(718) 398-3839
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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 R050967 NY Primary

Addresses

Primary practice location

567 9TH St
Brooklyn, NY 11215-4205

Mailing address

320 7TH Ave
Ste 227
Brooklyn, NY 11215-4113
Phone (718) 398-3839

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
I20050801000668 NY Practitioner - Clinical Social Worker 6608804612 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

567 9TH St
Brooklyn, NY 11215-4205
Phone (718) 398-3839

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R050967NYMDSocial Worker
050967NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1619917648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 7TH AVE",
            "address_2": "STE 227",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154113",
            "telephone_number": "718-398-3839",
            "fax_number": "718-398-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 9TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154205",
            "telephone_number": "718-398-3839",
            "fax_number": "718-398-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "JOAN",
        "middle_name": "P",
        "credential": "CSWR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "R050967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.