Active NPI
Gary Bynum
- Social Worker
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 082155-1
- Practice address
- 119 W 124TH St
New York, NY 10027-4920 - Phone
- (718) 260-2999
- Fax
- (718) 260-2999
- NPI assigned
- Jan 29, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 082155-1 | NY | Primary |
Addresses
Primary practice location
119 W 124TH St
New York, NY 10027-4920
Mailing address
22 Chapel St
Brooklyn, NY 11201-1903
Phone (718) 260-2999
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 082155-1 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supportive Care Psychology of Ny PC | Current | Accepting new patients |
Locations
27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951
48 Cedar St
Brooklyn, NY 11221
Phone (718) 455-6200
7810 164th St
Fresh Meadows, NY 11366
Phone (718) 429-2200
170 Lake St
Liberty, NY 12754
Phone (845) 292-4200
330 Chestnut St
Oneonta, NY 13820
Phone (607) 432-8500
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": "1517184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517184000000",
"number": "1841798519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 CHAPEL ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112011903",
"telephone_number": "718-260-2999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 W 124TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100274920",
"telephone_number": "718-260-2999",
"fax_number": "718-260-2999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYNUM",
"first_name": "GARY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-29",
"last_updated": "2018-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "082155-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.