Individual provider Active NPI

Elisa Shevlin, LMSW

  • Social Worker
  • Brooklyn, NY
National Provider Identifier
1659531267
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
0744901 Issued in NY
Practice address
800 Poly PL
Brooklyn, NY 11209-7104
Phone
(718) 836-6600
NPI assigned
Jun 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 0744901 NY Primary

Addresses

Primary practice location

800 Poly PL
Brooklyn, NY 11209-7104

Mailing address

800 Poly PL
Brooklyn, NY 11209-7104
Phone (718) 836-6600

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

535 Mack Ave
Kingsley, MI 49649-9220

60 Taylor St
Staten Island, NY 10310-1226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0744901NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1659531267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 POLY PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097104",
            "telephone_number": "718-836-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 POLY PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097104",
            "telephone_number": "718-836-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEVLIN",
        "first_name": "ELISA",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "0744901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.