Individual provider Active NPI

Joseph A Sarbak, LCSW

  • Clinical Social Worker
  • Erie, PA
National Provider Identifier
1669507125
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW016062 Issued in PA
Practice address
4508 Zuck Rd Ste 2
Erie, PA 16506-4523
Phone
(814) 833-4853
Fax
(814) 833-0438
NPI assigned
Feb 23, 2007
Last updated
Jun 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW013599L PA
Clinical Social Worker 1041C0700X CW016062 PA Primary

Addresses

Primary practice location

4508 Zuck Rd Ste 2
Erie, PA 16506-4523

Mailing address

4508 Zuck Rd Ste 2
Erie, PA 16506-4523
Phone (814) 833-4853

Other practice location 1

1338 E 38th St
Erie, PA 16504-3018
Phone (814) 825-2930

Other identifiers 2

IdentifierTypeStateIssuer
462600902OtherPATAX ID
1026257930005MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20081027000024 PA Practitioner - Clinical Social Worker 6204994866 Practice locations: Erie, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4380 W 12TH St
Erie, PA 16505-3028
Phone (814) 881-5277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW013599LPAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1669507125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4508 ZUCK RD STE 2",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064523",
            "telephone_number": "814-833-4853",
            "fax_number": "814-833-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4508 ZUCK RD STE 2",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064523",
            "telephone_number": "814-833-4853",
            "fax_number": "814-833-0438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1338 E 38th St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165043018",
            "country_code": "US",
            "telephone_number": "814-825-2930",
            "fax_number": "814-825-2964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SARBAK",
        "first_name": "JOSEPH",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW013599L",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "462600902",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1026257930005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.