Individual provider Active NPI

Debra Ann Malfatti, LCSW

  • Clinical Social Worker
  • Boynton Beach, FL
National Provider Identifier
1710014949
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO56279-1 Issued in NY
Practice address
1500 Gateway Blvd Ste 220
Boynton Beach, FL 33426-7233
Phone
(631) 874-9524
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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 RO56279-1 NY Primary

Addresses

Primary practice location

1500 Gateway Blvd Ste 220
Boynton Beach, FL 33426-7233

Mailing address

116 SW 14TH St
Boynton Beach, FL 33426-4642
Phone (631) 874-9524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20181129000883 FL Practitioner - Clinical Social Worker 2668716804 Practice locations: Boynton Beach, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1500 Gateway Blvd
Suite 220
Boynton Beach, FL 33426-7233
Phone (631) 874-9524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO56279-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515369600000",
    "number": "1710014949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 SW 14TH ST",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334264642",
            "telephone_number": "631-874-9524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 GATEWAY BLVD STE 220",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334267233",
            "telephone_number": "631-874-9524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALFATTI",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2018-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO56279-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.