Individual provider Active NPI

Pamela Amy Wach, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1639846207
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113546 Issued in NY
Practice address
220 E 42ND St FL 8
New York, NY 10017-5832
Phone
(650) 393-3935
NPI assigned
Aug 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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 113546 NY Primary

Addresses

Primary practice location

220 E 42ND St FL 8
New York, NY 10017-5832

Mailing address

220 E 42ND St FL 8
New York, NY 10017-5832

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
I20250116000884 NY Practitioner - Clinical Social Worker 3678001773 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Young Adult Institute IncGroup PAC ID 1153216353, 28 clinicians

Practice addresses (Care Compare)

227 E 41St St
FL 8
New York, NY 10017-6927
Phone (212) 273-6521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113546NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Healthcare, Inc. CurrentSince Dec 17, 2024 Accepting new patients
Young Adult Institute, Inc. CurrentSince Dec 17, 2024 Accepting new patients
Premier Healthcare, Inc. Current Accepting new patients

Locations

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

21111 Northern Blvd
#13292
Bayside, NY 11361
Phone (718) 705-1000

3060 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1790

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

220 E 42nd St
Fl 8
New York, NY 10017
Phone (212) 273-2761

Interoperability endpoints

  • Direct secure messaging: pamela.wach.p1@direct.premierhealthcare.nextgenshare.com

Organizations & group practices 3

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": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1639846207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E 42ND ST FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E 42ND ST FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175832",
            "telephone_number": "650-393-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACH",
        "first_name": "PAMELA",
        "middle_name": "AMY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "113546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.