Individual provider Active NPI

Larry Lee Rogers

  • Clinical Social Worker
  • Clifton, NJ
National Provider Identifier
1811582182
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00849900 Issued in NJ
Practice address
777 Bloomfield Ave
Clifton, NJ 07012-1242
Phone
(973) 594-0125
Fax
(973) 594-0536
NPI assigned
Mar 8, 2021
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 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 44SC00849900 NJ Primary

Addresses

Primary practice location

777 Bloomfield Ave
Clifton, NJ 07012-1242

Mailing address

685 Park Ave
Paterson, NJ 07504-1035
Phone (973) 204-5902

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lrogers@servbhs.org Direct

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
I20210420001937 NJ Practitioner - Clinical Social Worker 5991113573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Serv Centers of New Jersey, IncGroup PAC ID 8820983117, 10 clinicians

Practice addresses (Care Compare)

777 Bloomfield Ave
Clifton, NJ 07012-1242
Phone (973) 594-0125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Serv Centers of New Jersey, Inc CurrentSince Mar 1, 2021 Accepting new patients
Serv Centers of New Jersey, Inc CurrentSince Mar 1, 2021 Accepting new patients

Locations

777 Bloomfield Ave
Clifton, NJ 07012
Phone (973) 594-0125

777 Bloomfield Ave
Ste B
Clifton, NJ 07012
Phone (973) 594-0125

20 Scotch Rd
Ewing, NJ 08628
Phone (609) 403-6359

Organizations & group practices 2

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": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1811582182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 PARK AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075041035",
            "telephone_number": "973-204-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BLOOMFIELD AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121242",
            "telephone_number": "973-594-0125",
            "fax_number": "973-594-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "LARRY",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00849900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lrogers@servbhs.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 Bloomfield Ave",
            "city": "Clifton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070121242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.