Individual provider Active NPI

Skylar Hertzfeld

  • Clinical Social Worker
  • Vail, CO
National Provider Identifier
1629832613
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09926396 Issued in CO
Practice address
180 S Frontage Rd W
Vail, CO 81657-5038
Phone
(256) 797-0536
NPI assigned
Feb 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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 CSW.09926396 CO Primary

Addresses

Primary practice location

180 S Frontage Rd W
Vail, CO 81657-5038

Mailing address

PO Box 6744
Eagle, CO 81631-1039
Phone (256) 797-0536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20240320002513 CO Practitioner - Clinical Social Worker 5597102053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eagle Valley Mental HealthGroup PAC ID 6204297450, 32 clinicians

Practice addresses (Care Compare)

439 Edwards Access Rd
VHBH Wiegers Mental Health Clinic
Edwards, CO 81632-5634
Phone (970) 445-2489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Valley Mental Health CurrentSince Feb 19, 2024 Accepting new patients
Eagle Valley Mental Health Mental Health CurrentSince Feb 19, 2024 Accepting new patients

Locations

439 Edwards Access Rd
Edwards, CO 81632
Phone (970) 455-2489

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": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1629832613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6744",
            "city": "EAGLE",
            "state": "CO",
            "postal_code": "816311039",
            "telephone_number": "256-797-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S FRONTAGE RD W",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816575038",
            "telephone_number": "256-797-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZFELD",
        "first_name": "SKYLAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09926396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vail, CO

Sources for this page

Verify at the official NPI Registry.