Individual provider Active NPI

David John Mendelsohn, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1760560817
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
052476 Issued in NY
Practice address
117 Stanton St
6
New York, NY 10002-1527
Phone
(917) 902-3050
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 052476 NY Primary

Addresses

Primary practice location

117 Stanton St
6
New York, NY 10002-1527

Mailing address

117 Stanton St
6
New York, NY 10002-1527
Phone (917) 902-3050

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
I20070301000422 NY Practitioner - Clinical Social Worker 9133221690 Practice locations: New York, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
052476NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Stanley R Graham PH D PC PastSince May 1, 2008 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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760560817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 STANTON ST",
            "address_2": "6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100021527",
            "telephone_number": "917-902-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 STANTON ST",
            "address_2": "6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100021527",
            "telephone_number": "917-902-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDELSOHN",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "052476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.