Individual provider Active NPI

Gerald J Rodriguez, LSW

  • Clinical Social Worker
  • Allentown, PA
National Provider Identifier
1639124753
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW006715L Issued in PA
Practice address
1243 S Cedar Crest Blvd Ste 2200
Allentown, PA 18103-6268
Phone
(610) 402-2500
Fax
(610) 402-2506
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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 CW006715L PA Primary

Addresses

Primary practice location

1243 S Cedar Crest Blvd Ste 2200
Allentown, PA 18103-6268

Mailing address

1605 N Cedar Crest Blvd Ste 411
Allentown, PA 18104-2323
Phone (610) 969-1914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080212000303 PA Practitioner - Clinical Social Worker 2466366224 Reassigns benefits to 1 organization
Practice locations: Coopersburg, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6700 Walnut LN
Coopersburg, PA 18036-1126
Phone (484) 201-7121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW006715LPAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Feb 1, 2019 Accepting new patients
Hazleton Professional Services Current Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Jun 1, 2017 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jun 1, 2017 Accepting new patients
The Guidance Program Past Accepting new patients

Locations

1259 S Cedar Crest Blvd
Allentown, PA 18103
Phone (610) 402-1757

1243 S Cedar Crest Blvd
Ste 2200
Allentown, PA 18103
Phone (610) 402-2500

2545 Schoenersville Rd
Bethlehem, PA 18017
Phone (484) 884-2888

2545 Schoenersville Rd
Fl 5
Bethlehem, PA 18017
Phone (484) 884-6500

1650 Valley Center Pkwy
Bethlehem, PA 18017

50 Moisey Dr
Ste 109
Hazle Township, PA 18202
Phone (570) 501-6460

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

Organizations & group practices 6

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1639124753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 N CEDAR CREST BLVD STE 411",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042323",
            "telephone_number": "610-969-1914",
            "fax_number": "610-969-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 S CEDAR CREST BLVD STE 2200",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036268",
            "telephone_number": "610-402-2500",
            "fax_number": "610-402-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "GERALD",
        "middle_name": "J",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW006715L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.