Individual provider Active NPI

Elvira Maria Medus, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1841558954
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079337-1 Issued in NY
Practice address
1 Milligan PL
New York, NY 10011-8374
Phone
(773) 573-8254
NPI assigned
Apr 26, 2012
Last updated
Apr 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 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 079337-1 NY Primary

Addresses

Primary practice location

1 Milligan PL
New York, NY 10011-8374

Mailing address

1 Milligan PL
New York, NY 10011-8374
Phone (773) 573-8254

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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
079337-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1841558954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MILLIGAN PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118374",
            "telephone_number": "773-573-8254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MILLIGAN PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118374",
            "telephone_number": "773-573-8254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDUS",
        "first_name": "ELVIRA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079337-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.