Active NPI
Shannon Perez, LMSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1770011694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 096229
- Practice address
- 462 1St Ave FL 2
New York, NY 10016-9196 - Phone
- (212) 562-7443
- Fax
- (212) 562-3809
- NPI assigned
- May 24, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 096229 | NY | Primary |
Addresses
Primary practice location
462 1St Ave FL 2
New York, NY 10016-9196
Mailing address
462 1St Ave FL 2
New York, NY 10016-9196
Phone (212) 562-7443
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: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230109002940 | NY | Order and Referring Only - Other (Physician) | 0143690156 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096229 | NY | MD | Clinical Social Worker |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1770011694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "462 1ST AVE FL 2",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100169196",
"telephone_number": "212-562-7443",
"fax_number": "212-562-3809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "462 1ST AVE FL 2",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100169196",
"telephone_number": "212-562-7443",
"fax_number": "212-562-3809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "SHANNON",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-24",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "096229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.