Individual provider Active NPI

Jehremi Rene Clavareza, LCSW

  • Clinical Social Worker
  • Doral, FL
National Provider Identifier
1659040558
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15944 Issued in FL
Practice address
2670 NW 84TH Ave Apt 105
Doral, FL 33122-1548
Phone
(305) 609-5312
NPI assigned
Sep 13, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 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 15944 FL Primary

Addresses

Primary practice location

2670 NW 84TH Ave Apt 105
Doral, FL 33122-1548

Mailing address

2670 NW 84TH Ave Apt 105
Doral, FL 33122-1548
Phone (305) 609-5312

Other identifiers 1

IdentifierTypeStateIssuer
N21000001650OtherFLNOT A MDCR PROVIDER AT THIS TIME

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Alma Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240808001814 FL Practitioner - Clinical Social Worker 8729525720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15944FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Jul 2, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1659040558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 NW 84TH AVE APT 105",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331221548",
            "telephone_number": "305-609-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 NW 84TH AVE APT 105",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331221548",
            "telephone_number": "305-609-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAVAREZA",
        "first_name": "JEHREMI",
        "middle_name": "RENE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "15944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOT A MDCR PROVIDER AT THIS TIME",
            "identifier": "N21000001650",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Alma",
            "affiliation": "N",
            "endpointDescription": "Communication hub",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Electronic file",
            "address_1": "2670 NW 84th Ave Apt 105",
            "city": "Doral",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331221548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.