Individual provider Active NPI

Yedida Phyllis Sachs, L.C.S.W.

  • Clinical Social Worker
  • Teaneck, NJ
National Provider Identifier
1649271545
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R032300-1 Issued in NY
Practice address
1029 Teaneck Rd
Suite 2B
Teaneck, NJ 07666-4514
Phone
(845) 304-2368
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC04751800 NJ
Clinical Social Worker 1041C0700X R032300-1 NY Primary

Addresses

Primary practice location

1029 Teaneck Rd
Suite 2B
Teaneck, NJ 07666-4514

Mailing address

28 Falcon Way
Washington, NJ 07882-4089
Phone (845) 304-2368

Other identifiers 1

IdentifierTypeStateIssuer
11496161OtherNJCAQH

Other names 1

  • Phyllis Sachs Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20170209000522 NJ Practitioner - Clinical Social Worker 3577846971 Practice locations: Teaneck, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1029 Teaneck Rd
Suite 2B
Teaneck, NJ 07666-4514
Phone (845) 304-2368

992 Richard CT
Teaneck, NJ 07666-5512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC04751800NJMDClinical Social Worker
R032300-1NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1649271545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 FALCON WAY",
            "city": "WASHINGTON",
            "state": "NJ",
            "postal_code": "078824089",
            "telephone_number": "845-304-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 TEANECK RD",
            "address_2": "SUITE 2B",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664514",
            "telephone_number": "845-304-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACHS",
        "first_name": "YEDIDA",
        "middle_name": "PHYLLIS",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04751800",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R032300-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11496161",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHYLLIS",
            "last_name": "SACHS",
            "credential": "L.C.S.W",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.