Active NPI
Shirley Nadine Jimenez, LMSW
- Social Worker
- New York, NY
National Provider Identifier
1659082147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 117025
- Practice address
- 3940 Broadway
New York, NY 10032-1534 - Phone
- (212) 781-5500
- Fax
- (212) 927-6089
- NPI assigned
- Dec 6, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 117025 | NY | Primary |
Addresses
Primary practice location
3940 Broadway
New York, NY 10032-1534
Mailing address
311 E 175TH St
Bronx, NY 10457-5859
Phone (718) 960-7605
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 117025 | Other | NY | LICENSE REGISTRATION |
| 494023663 | Other | NY | DRIVER LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sjimenez@acdp.org |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acdp | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- New York, NY
- NPI 1396997201
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670284800000",
"number": "1659082147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 E 175TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104575859",
"telephone_number": "718-960-7605",
"fax_number": "718-583-6439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3940 BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100321534",
"telephone_number": "212-781-5500",
"fax_number": "212-927-6089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "SHIRLEY",
"middle_name": "NADINE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-06",
"last_updated": "2022-12-06",
"certification_date": "2022-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "117025",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE REGISTRATION",
"identifier": "117025",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER LICENSE",
"identifier": "494023663",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sjimenez@acdp.org",
"affiliation": "N",
"address_1": "3940 Broadway",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100321534",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.