Active NPI
Michelle Diaz-Gautreau
- Clinical Social Worker
- Jamaica, NY
National Provider Identifier
1881097111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 086893
- Practice address
- 89-44 164TH St
Jamaica, NY 11432-6103 - Phone
- (718) 523-2123
- Fax
- (718) 523-5833
- NPI assigned
- Oct 1, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 092049 | NY | |
| Clinical Social Worker | 1041C0700X | 086893 | NY | Primary |
Addresses
Primary practice location
89-44 164TH St
Jamaica, NY 11432-6103
Mailing address
60 Madison Ave FL 5
New York, NY 10010-1600
Phone (212) 545-2409
Other practice location 1
350 Grand St Rm 240
New York, NY 10002-4629
Phone (212) 634-7550 ext. 7556
Other practice location 2
504 W 158th St Fl 5
New York, NY 10032-7202
Phone (917) 521-3130 ext. 3130
Other practice location 3
2581 Atlantic Ave
Brooklyn, NY 11207-2412
Phone (718) 495-6700
Other practice location 4
1167 Nostrand Ave
Brooklyn, NY 11225-5417
Phone (718) 778-0198
Other practice location 5
36-11 21st St
Long Island City, NY 11106-4505
Phone (718) 482-7772
Other practice location 6
975 Westchester Ave
Bronx, NY 10459-3204
Phone (718) 320-4466
Other practice location 7
94-98 Manhattan Avenue
Brooklyn, NY 11206-2505
Phone (718) 388-0390
Other practice location 8
4215 3rd Ave Fl 2
Bronx, NY 10457-4501
Phone (718) 294-5891
Other practice location 9
999 Blake Ave
Brooklyn, NY 11208-3535
Phone (718) 277-8303
Other practice location 10
81 W 115th St
New York, NY 10026-3138
Phone (212) 426-0088
Other practice location 11
511 W 157TH St
New York, NY 10032-5058
Phone (212) 781-7979
Other practice location 12
255 E Houston St
New York, NY 10002-1013
Phone (212) 477-1120
Other practice location 13
150 Essex St
New York, NY 10002-2301
Phone (212) 477-1120
Other practice location 14
16 E 16th St Fl 1
New York, NY 10003-3105
Phone (212) 206-5200
Other practice location 15
9704 Sutphin Blvd
Jamaica, NY 11435
Phone (718) 657-7088
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 |
|---|---|---|---|
| 092049 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| Community Healthcare Network, Inc. | Past | Accepting new patients |
Locations
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
7559 263rd St
Glen Oaks, NY 11004
Phone (718) 470-8005
1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Organizations & group practices 2
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.
-
dba NHPP Cardiology at Great Neck
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
dba Phoenix School Based Health Center
- Federally Qualified Health Center (FQHC)
- New York, NY
- NPI 1912436858
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708560000000",
"number": "1881097111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 MADISON AVE FL 5",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100101600",
"telephone_number": "212-545-2409",
"fax_number": "646-312-0481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "89-44 164TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114326103",
"telephone_number": "718-523-2123",
"fax_number": "718-523-5833"
}
],
"practiceLocations": [
{
"address_1": "350 Grand St Rm 240",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100024629",
"country_code": "US",
"telephone_number": "212-634-7550 x7556",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "504 W 158th St Fl 5",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100327202",
"country_code": "US",
"telephone_number": "917-521-3130 x3130",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2581 Atlantic Ave",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112072412",
"country_code": "US",
"telephone_number": "718-495-6700",
"fax_number": "646-988-2840",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1167 Nostrand Ave",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112255417",
"country_code": "US",
"telephone_number": "718-778-0198",
"fax_number": "718-221-8169",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "36-11 21st St",
"address_purpose": "LOCATION",
"city": "Long Island City",
"state": "NY",
"postal_code": "111064505",
"country_code": "US",
"telephone_number": "718-482-7772",
"fax_number": "718-482-9648",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "975 Westchester Ave",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104593204",
"country_code": "US",
"telephone_number": "718-320-4466",
"fax_number": "718-991-3829",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "94-98 Manhattan Avenue",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112062505",
"country_code": "US",
"telephone_number": "718-388-0390",
"fax_number": "718-486-5741",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4215 3rd Ave Fl 2",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104574501",
"country_code": "US",
"telephone_number": "718-294-5891",
"fax_number": "718-294-2468",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "999 Blake Ave",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112083535",
"country_code": "US",
"telephone_number": "718-277-8303",
"fax_number": "718-277-4795",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "81 W 115th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100263138",
"country_code": "US",
"telephone_number": "212-426-0088",
"fax_number": "212-426-8367",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "511 W 157TH ST",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100325058",
"country_code": "US",
"telephone_number": "212-781-7979",
"fax_number": "212-781-7963",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "255 E Houston St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100021013",
"country_code": "US",
"telephone_number": "212-477-1120",
"fax_number": "212-477-8957",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "150 Essex St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100022301",
"country_code": "US",
"telephone_number": "212-477-1120",
"fax_number": "212-477-8957",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16 E 16th St Fl 1",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100033105",
"country_code": "US",
"telephone_number": "212-206-5200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9704 Sutphin Blvd",
"address_purpose": "LOCATION",
"city": "Jamaica",
"state": "NY",
"postal_code": "11435",
"country_code": "US",
"telephone_number": "718-657-7088",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIAZ-GAUTREAU",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-01",
"last_updated": "2024-02-22",
"certification_date": "2024-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "092049",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "086893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.