Individual provider Active NPI

Jon Hildebrandt

  • Social Worker
  • Flushing, NY
National Provider Identifier
1770019119
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
090694-01 Issued in NY
Practice address
144-60 Sanford Ave. Apt.10
Flushing, NY 11355
Phone
(718) 791-1917
NPI assigned
May 4, 2017
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 099455-1 NY
Social Worker 104100000X 090694-01 NY Primary

Addresses

Primary practice location

144-60 Sanford Ave. Apt.10
Flushing, NY 11355

Mailing address

14460 Sanford Ave Apt 10
Flushing, NY 11355-1624
Phone (718) 791-1917

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
I20210212001852 NY Practitioner - Clinical Social Worker 8022423672 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
090694-01NYMDSocial Worker
099455-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Child Center of Ny, Inc. CurrentSince Jul 26, 2025 Accepting new patients

Locations

11835 Queens Blvd
Fl 6
Forest Hills, NY 11375
Phone (718) 851-7770

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, 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": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1770019119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14460 SANFORD AVE APT 10",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551624",
            "telephone_number": "718-791-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144-60 SANFORD AVE. APT.10",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-791-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDEBRANDT",
        "first_name": "JON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-04",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "099455-1",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "090694-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.