Individual provider Active NPI

Dewan Chand Bajaj, LMSW

  • Social Worker
  • Bay Shore, NY
National Provider Identifier
1669815338
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
080808-1 Issued in NY
Practice address
1444 5TH Ave
Bay Shore, NY 11706-4147
Phone
(631) 647-3100
NPI assigned
Apr 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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 080808-1 NY Primary

Addresses

Primary practice location

1444 5TH Ave
Bay Shore, NY 11706-4147

Mailing address

1444 5TH Ave
Bay Shore, NY 11706-4147
Phone (631) 647-3100

Other identifiers 1

IdentifierTypeStateIssuer
UNKNOWNOtherNYBLUE CROSS BLUE SHIELD

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
080808-1NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1669815338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 5TH AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064147",
            "telephone_number": "631-647-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 5TH AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064147",
            "telephone_number": "631-647-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJAJ",
        "first_name": "DEWAN",
        "middle_name": "CHAND",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "080808-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "UNKNOWN",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.