Active NPI
Dore Mann
- Clinical Social Worker
- Woodside, NY
National Provider Identifier
1669874327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 089817
- Practice address
- 4747 46TH St Apt 1F
Woodside, NY 11377-6544 - Phone
- (347) 843-3692
- NPI assigned
- Sep 24, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089817 | NY | Primary |
Addresses
Primary practice location
4747 46TH St Apt 1F
Woodside, NY 11377-6544
Mailing address
47-47 46 Street Apartment 1F
Woodside, NY 11377
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 777777 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2012
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Dallas, TX 75373
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 089817 | NY | MD | Clinical Social Worker |
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": "1411516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411516800000",
"number": "1669874327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47-47 46 STREET APARTMENT 1F",
"city": "WOODSIDE",
"state": "NY",
"postal_code": "11377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4747 46TH ST APT 1F",
"city": "WOODSIDE",
"state": "NY",
"postal_code": "113776544",
"telephone_number": "347-843-3692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANN",
"first_name": "DORE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-24",
"last_updated": "2014-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "089817",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "777777",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.