Individual provider Active NPI

Paul Edward Rutz-Zenov, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1841300829
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
077665 Issued in NY
Practice address
502 W 47TH St
3E
New York, NY 10036-2220
Phone
(212) 246-8375
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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 077665 NY Primary

Addresses

Primary practice location

502 W 47TH St
3E
New York, NY 10036-2220

Mailing address

502 W 47TH St
3E
New York, NY 10036-2220
Phone (212) 246-8375

Other identifiers 1

IdentifierTypeStateIssuer
00244624MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20131023001256 NY Practitioner - Clinical Social Worker 0840425112 Practice locations: New York, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077665NYMDClinical Social Worker

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1841300829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W 47TH ST",
            "address_2": "3E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100362220",
            "telephone_number": "212-246-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W 47TH ST",
            "address_2": "3E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100362220",
            "telephone_number": "212-246-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTZ-ZENOV",
        "first_name": "PAUL",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244624",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.