Individual provider Active NPI

Kristen Nedelkoff, LCSW

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1801564497
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23938 Issued in TX
Practice address
5939 Harry Hines Blvd Ste 334
Dallas, TX 75235-6246
Phone
(214) 645-0599
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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 23938 TX Primary

Addresses

Primary practice location

5939 Harry Hines Blvd Ste 334
Dallas, TX 75235-6246

Mailing address

PO Box 845347
Dallas, TX 75284-7208

Other identifiers 1

IdentifierTypeStateIssuer
23938OtherTXTEXAS STATE BOARD OF SOCIAL WORK EXAMINERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23938TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 23, 2021 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 23, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

5939 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 645-1919

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

5939 Harry Hines Blvd
Ste 334
Dallas, TX 75235
Phone (214) 645-0599

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 3

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": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1801564497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5939 HARRY HINES BLVD STE 334",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752356246",
            "telephone_number": "214-645-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEDELKOFF",
        "first_name": "KRISTEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "23938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF SOCIAL WORK EXAMINERS",
            "identifier": "23938",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.