Individual provider Active NPI

Gina Gates, LCSW

  • Clinical Social Worker
  • New Britain, CT
National Provider Identifier
1790306967
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12379 Issued in CT
Practice address
75 N Mountain Rd
New Britain, CT 06053-3468
Phone
(860) 793-3500
NPI assigned
Apr 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 12379 CT Primary

Addresses

Primary practice location

75 N Mountain Rd
New Britain, CT 06053-3468

Mailing address

100 Myron St
New Haven, CT 06512-3951
Phone (203) 988-0611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20220923002011 CT Practitioner - Clinical Social Worker 0547645798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeler Clinic IncGroup PAC ID 0345147153, 105 clinicians

Practice addresses (Care Compare)

40 Hart St
New Britain, CT 06052-1759
Phone (860) 793-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: gina.gates.p1@direct.wheelerclinic.nextgenshare.com

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": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1790306967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MYRON ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065123951",
            "telephone_number": "203-988-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 N MOUNTAIN RD",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060533468",
            "telephone_number": "860-793-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "GINA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "12379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Britain, CT

Sources for this page

Verify at the official NPI Registry.