Individual provider Active NPI

Anna Mierkiewicz, LCSW

  • Clinical Social Worker
  • Margate City, NJ
National Provider Identifier
1780136994
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05620200 Issued in NJ
Practice address
607 N Jerome Ave
Margate City, NJ 08402-1527
Phone
(609) 822-1108
Fax
(609) 822-1106
NPI assigned
Nov 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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 44SC05620200 NJ Primary

Addresses

Primary practice location

607 N Jerome Ave
Margate City, NJ 08402-1527

Mailing address

607 N Jerome Ave
Margate City, NJ 08402-1527
Phone (609) 822-1108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20170105002241 NJ Practitioner - Clinical Social Worker 6103107198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jewish Family Service of Atlantic CountyGroup PAC ID 1052304573, 8 clinicians

Practice addresses (Care Compare)

607 N Jerome Ave
Margate, NJ 08402-1527
Phone (609) 822-1108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05620200NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Service of Atlantic County CurrentSince Nov 1, 2016 Accepting new patients

Locations

607 N Jerome Ave
Margate City, NJ 08402
Phone (609) 822-1108

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": "1478217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1780136994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 N JEROME AVE",
            "city": "MARGATE CITY",
            "state": "NJ",
            "postal_code": "084021527",
            "telephone_number": "609-822-1108",
            "fax_number": "609-822-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 N JEROME AVE",
            "city": "MARGATE CITY",
            "state": "NJ",
            "postal_code": "084021527",
            "telephone_number": "609-822-1108",
            "fax_number": "609-822-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIERKIEWICZ",
        "first_name": "ANNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-04",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05620200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Margate City, NJ

Sources for this page

Verify at the official NPI Registry.