Individual provider Active NPI

Nancy Jeanette Gomolinski, LCSW

  • Clinical Social Worker
  • Bergenfield, NJ
National Provider Identifier
1700986890
Registry record updated Jul 9, 2007
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(3) exclusion effective Mar 20, 2014.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC04812000 Issued in NJ
Practice address
74 Westminster Ave
Bergenfield, NJ 07621-3916
Phone
(201) 638-3662
Fax
(201) 385-9113
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 44SC04812000 NJ Primary

Addresses

Primary practice location

74 Westminster Ave
Bergenfield, NJ 07621-3916

Mailing address

74 Westminster Ave
Bergenfield, NJ 07621-3916
Phone (201) 638-3662

Other identifiers 1

IdentifierTypeStateIssuer
0039691MedicaidNJ

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Next Step Chiropractic LLC Past Accepting new patients

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1700986890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 WESTMINSTER AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076213916",
            "telephone_number": "201-638-3662",
            "fax_number": "201-385-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 WESTMINSTER AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076213916",
            "telephone_number": "201-638-3662",
            "fax_number": "201-385-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMOLINSKI",
        "first_name": "NANCY",
        "middle_name": "JEANETTE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04812000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0039691",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bergenfield, NJ

Sources for this page

Verify at the official NPI Registry.