Individual provider Active NPI

Shirley Capa

  • Clinical Social Worker
  • Yonkers, NY
National Provider Identifier
1689128589
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
097884 Issued in NY
Practice address
1156 N Broadway
Yonkers, NY 10701-1108
Phone
(914) 965-3700
NPI assigned
Aug 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 097884 NY Primary

Addresses

Primary practice location

1156 N Broadway
Yonkers, NY 10701-1108

Mailing address

1156 N Broadway
Yonkers, NY 10701-1108
Phone (914) 965-3700

Other identifiers 3

IdentifierTypeStateIssuer
WVE061OtherNYMEDICARE #
00355940MedicaidNY
1285628552OtherNYAGENCY

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
089520NYMDClinical Social Worker
097884NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Julia Dyckman Andrus Memorial, Inc. CurrentSince Mar 1, 2021 Accepting new patients

Locations

19 Greenridge Ave
White Plains, NY 10605
Phone (914) 949-7680

1156 N Broadway
Yonkers, NY 10701
Phone (914) 965-3700

35 Dock St
Yonkers, NY 10701
Phone (914) 965-1109

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": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1689128589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 N BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011108",
            "telephone_number": "914-965-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 N BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011108",
            "telephone_number": "914-965-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPA",
        "first_name": "SHIRLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE #",
            "identifier": "WVE061",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00355940",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY",
            "identifier": "1285628552",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.