Active NPI
James Dennis Gitar, LICSW
- Clinical Social Worker
- Edina, MN
National Provider Identifier
1639351844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6714
- Practice address
- 6550 York Ave S Ste 503
Edina, MN 55435 - Phone
- (952) 426-3034
- Fax
- (612) 540-0460
- NPI assigned
- Nov 29, 2007
- Last updated
- Aug 22, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6714 | MN | Primary |
Addresses
Primary practice location
6550 York Ave S Ste 503
Edina, MN 55435
Mailing address
6550 York Ave S Ste 503
Edina, MN 55435-2336
Phone (952) 426-3034
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1980
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
6550 York Ave S
Suite 417
Edina, MN 55435-2336
Phone (952) 426-3034
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6714 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Mullenbach, PHD, LP, Inc | Current | Accepting new patients |
Locations
6550 York Ave S
Ste 417
Minneapolis, MN 55435
Phone (952) 426-3034
6550 York Ave S
Ste 503
Minneapolis, MN 55435
Phone (952) 426-3034
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534896000000",
"number": "1639351844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6550 YORK AVE S STE 503",
"city": "EDINA",
"state": "MN",
"postal_code": "554352336",
"telephone_number": "952-426-3034",
"fax_number": "612-540-0460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6550 YORK AVE S STE 503",
"city": "EDINA",
"state": "MN",
"postal_code": "55435",
"telephone_number": "952-426-3034",
"fax_number": "612-540-0460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GITAR",
"first_name": "JAMES",
"middle_name": "DENNIS",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-29",
"last_updated": "2018-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "6714",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.