Organization Active NPI

Jermaine Hill LCSW Family Services PC

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1881170959
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
086300-1 Issued in NY
Legal business name
JERMAINE HILL LCSW FAMILY SERVICES PC
Practice address
60 Bay St Ste 710
Staten Island, NY 10301-2541
Phone
(347) 881-3407
Fax
(718) 816-0048
NPI assigned
Jul 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Authorized official

Name
Mr. Jermaine K Hill, LCSWNPI 1366739641
Title
Ceo
Phone
(347) 881-3407

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 086300-1 NY Primary

Addresses

Primary practice location

60 Bay St Ste 710
Staten Island, NY 10301-2541

Mailing address

67 Railroad Ave
Staten Island, NY 10305-4734
Phone (718) 689-2950

Other identifiers 1

IdentifierTypeStateIssuer
1366739641MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190124000824 NY Part B Supplier - Clinic/Group Practice 2163769449 Receives reassigned benefits from 1 practitioner
Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory

Locations

60 Bay St
Ste 710
Staten Island, NY 10301
Phone (347) 881-3407

568 Bay St
Ste 3
Staten Island, NY 10304
Phone (347) 801-7786

420 South Ave
Ste 4B
Staten Island, NY 10303
Phone (347) 881-3407

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531353600000",
    "number": "1881170959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 RAILROAD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054734",
            "telephone_number": "718-689-2950",
            "fax_number": "718-816-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 BAY ST STE 710",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012541",
            "telephone_number": "347-881-3407",
            "fax_number": "718-816-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERMAINE HILL LCSW FAMILY SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "JERMAINE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-881-3407",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086300-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366739641",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.