Pearl Broder, L..C.S.W,

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R016272-1 Issued in NY

Practice address

52 W 12TH St
New York, NY 10011-8641

Phone

(212) 691-6712

Fax

(212) 691-6712

NPI assigned

Jan 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

New York University School of Medicine, 1966

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1861543324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 W 12TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118641",
            "telephone_number": "212-691-6712",
            "fax_number": "212-691-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 W 12TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118641",
            "telephone_number": "212-691-6712",
            "fax_number": "212-691-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODER",
        "first_name": "PEARL",
        "name_prefix": "Ms.",
        "credential": "L..C.S.W,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R016272-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01707877",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel Brodbar, LMSW
• Alexis Brode, LMSW
• Andrew Ross Broden, RD
• Joshua Broden, MD
• Emily Brienne Broder, OD
• Martha Broderick, L.C.S.W.
• Janis Ellen Brodie, LCSW
• Jonathan D Brodie, M.D.
• Scott E Brodie, MD
• Tammie F Brodie, ANP-BC

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.