Individual provider Active NPI

Jesse Lee Pietroniro, LCSW

  • Clinical Social Worker
  • Irvington, NY
National Provider Identifier
1639508815
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
085150 Issued in NY
Practice address
63 Sunnyside PL
Irvington, NY 10533-1338
Phone
(413) 209-0487
NPI assigned
Nov 7, 2013
Last updated
Mar 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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 085150 NY Primary

Addresses

Primary practice location

63 Sunnyside PL
Irvington, NY 10533-1338

Mailing address

63 Sunnyside PL
Irvington, NY 10533-1338
Phone (413) 209-0487

Other practice location 1

104-70 Queens Blvd
Ste 200
Forest Hills, NY 11375
Phone (718) 275-6010

Other practice location 2

26 W 9th St Apt 3E
New York, NY 10011-8923
Phone (413) 209-0487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
085150NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bleuler Psychotherapy Center, Inc. PastSince Mar 10, 1999 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/bleulerpc/r4/

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": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1639508815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 SUNNYSIDE PL",
            "city": "IRVINGTON",
            "state": "NY",
            "postal_code": "105331338",
            "telephone_number": "413-209-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 SUNNYSIDE PL",
            "city": "IRVINGTON",
            "state": "NY",
            "postal_code": "105331338",
            "telephone_number": "413-209-0487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104-70 Queens Blvd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "11375",
            "country_code": "US",
            "telephone_number": "718-275-6010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26 W 9th St Apt 3E",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100118923",
            "country_code": "US",
            "telephone_number": "413-209-0487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIETRONIRO",
        "first_name": "JESSE",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-07",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.