Individual provider Active NPI

Altagracia Martinez, MSW

  • Clinical Social Worker
  • Rego Park, NY
National Provider Identifier
1760721088
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
9729 64TH Rd
Rego Park, NY 11374-2259
Phone
(718) 896-3400
Fax
(718) 459-5621
NPI assigned
Feb 6, 2013
Last updated
Feb 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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 Primary

Addresses

Primary practice location

9729 64TH Rd
Rego Park, NY 11374-2259

Mailing address

406 E 161St St
Apt 9K
Bronx, NY 10451-4173
Phone (718) 666-6987

Other identifiers 1

IdentifierTypeStateIssuer
00244019MedicaidNY

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
I20161020001052 NY Practitioner - Clinical Social Worker 3072891381 Reassigns benefits to 3 organizations
Practice locations: Woodbury, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7600 Jericho Tpke
Suite C102
Woodbury, NY 11797-1714
Phone (631) 517-0466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Am Counseling Services LCSW P.C. Clinical CurrentSince Feb 14, 2020 Accepting new patients
Long Island Consultation Center, Inc. Clinical CurrentSince Jul 30, 2016 Accepting new patients
Queens Psychotherapy LCSW Services P.C. Clinical CurrentSince Aug 1, 2019 Accepting new patients
Long Island Consultation Center PastSince Aug 15, 2021 Accepting new patients

Locations

9131 Queens Blvd
Ste 222
Elmhurst, NY 11373
Phone (718) 896-3400

9520 63rd Rd
Ste J
Rego Park, NY 11374
Phone (718) 459-5812

7600 Jericho Tpke
Ste C101
Woodbury, NY 11797
Phone (516) 319-1202

7600 Jericho Tpke
Ste C102
Woodbury, NY 11797
Phone (718) 666-6987

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1760721088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 E 161ST ST",
            "address_2": "APT 9K",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104514173",
            "telephone_number": "718-666-6987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9729 64TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742259",
            "telephone_number": "718-896-3400",
            "fax_number": "718-459-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ALTAGRACIA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-06",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244019",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.