Individual provider Active NPI

Jacqueline Ann Yaman, LMSW

  • Clinical Social Worker
  • Cortland, NY
National Provider Identifier
1710289459
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
085122-1 Issued in NY
Practice address
7 Clayton Ave
Cortland, NY 13045-2501
Phone
(607) 758-6100
Fax
(607) 758-6116
NPI assigned
Dec 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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 085122-1 NY Primary

Addresses

Primary practice location

7 Clayton Ave
Cortland, NY 13045-2501

Mailing address

7 Clayton Ave
Cortland, NY 13045-2501
Phone (607) 758-6100

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170131000241 NY Practitioner - Clinical Social Worker 7911289723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cortland County County TreasurerGroup PAC ID 3173427028, 17 clinicians

Practice addresses (Care Compare)

111 Port Watson St
Cortland, NY 13045-3185
Phone (607) 428-5461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085122-1NYMDClinical 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": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1710289459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CLAYTON AVE",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452501",
            "telephone_number": "607-758-6100",
            "fax_number": "607-758-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CLAYTON AVE",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452501",
            "telephone_number": "607-758-6100",
            "fax_number": "607-758-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAN",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-01",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085122-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, NY

Sources for this page

Verify at the official NPI Registry.