Individual provider Active NPI

Carmelo A Colon

  • Social Worker
  • Newark, NJ
National Provider Identifier
1801992201
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SC00041000 Issued in NJ
Practice address
183 South Orange Ave
Newark, NJ 07103
Phone
(800) 969-5300
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SC00041000 NJ Primary

Addresses

Primary practice location

183 South Orange Ave
Newark, NJ 07103

Mailing address

671 Hoes LN
Piscataway, NJ 08854-5627

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
I20050420000575 NJ Practitioner - Clinical Social Worker 1951349919 Reassigns benefits to 1 organization
Practice locations: Upper Montclair, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeside Counseling Associates, LLCGroup PAC ID 0840568754, 26 clinicians

Practice addresses (Care Compare)

30 Moran St
Newton, NJ 07860-1832
Phone (973) 726-4533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC00041000NJMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Counseling Associates, LLC CurrentSince Apr 26, 2017 Accepting new patients

Locations

30 Moran St
Newton, NJ 07860
Phone (973) 579-3101

9 Fishers Ln
Ste E
Sparta, NJ 07871
Phone (973) 600-3558

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801992201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 HOES LN",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088545627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 SOUTH ORANGE AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07103",
            "telephone_number": "800-969-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON",
        "first_name": "CARMELO",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SC00041000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.