Ivan De Jesus Hernandez-Guzman, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

121465 Issued in NY

Practice address

777 Seaview Ave
Staten Island, NY 10305-3409

Phone

(718) 667-2690

NPI assigned

Oct 21, 2024

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: ivan.hernandez@omh.ny.gov

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1831910926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 PULASKI AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053409",
            "telephone_number": "718-667-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ-GUZMAN",
        "first_name": "IVAN",
        "middle_name": "DE JESUS",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "121465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ivan.Hernandez@omh.ny.gov",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 Seaview Ave",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103053409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hermanos Pharmacy RX Inc.
• Gerardo Viernes Hermogenes
• Marisela Hernandez Balderas, RN
• Juan P Hernandez Gomez, MD
• Sebastian Hernandez Mejia, M.D.
• Adia Isabel Hernandez
• Angie Lorena Hernandez, MD
• Catherine Hernandez, LCSW
• Daniel Jonah Hernandez, ATS
• Daniela Hernandez

• Social Worker in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.