Individual provider Active NPI

David William Hayes

  • Clinical Social Worker
  • Santa Cruz, CA
National Provider Identifier
1740321470
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 69740 Issued in CA
Practice address
1400 Emeline Ave
Santa Cruz, CA 95060-1976
Phone
(831) 454-4100
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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 LCSW 69740 CA Primary

Addresses

Primary practice location

1400 Emeline Ave
Santa Cruz, CA 95060-1976

Mailing address

115 A Coral Ave
Santa Cruz, CA 95065-1201

Other identifiers 3

IdentifierTypeStateIssuer
FHC 700 42FOtherCAMEDI-CAL GROUP PTAN# FOR SANTA CRUZ COUNTY
ZZZ92069ZOtherCAMEDICARE GROUP PTAN# FOR SANTA CRUZ COUNTY
ZZZ91891ZOtherCAMEDICARE GROUP PTAN# FOR SANTA CRUZ COUNTY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20161230001548 CA Practitioner - Clinical Social Worker 5294016416 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
County of Santa CruzGroup PAC ID 7618872912, 65 clinicians

Practice addresses (Care Compare)

1400 Emeline Ave
Santa Cruz, CA 95060-1976
Phone (831) 454-4971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 69740CAMDClinical Social Worker
69740CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Puentes Al Sur Past Accepting new patients

Organizations & group practices 2

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1740321470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 A CORAL AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601976",
            "telephone_number": "831-454-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "DAVID",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW 69740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL GROUP PTAN# FOR SANTA CRUZ COUNTY",
            "identifier": "FHC 700 42F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN# FOR SANTA CRUZ COUNTY",
            "identifier": "ZZZ92069Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN# FOR SANTA CRUZ COUNTY",
            "identifier": "ZZZ91891Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.