Individual provider Active NPI

Judith Gringorten, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1881617264
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R016606-1 Issued in NY
Practice address
853 Broadway
Suite 1608
New York, NY 10003-4703
Phone
(212) 982-8835
Fax
(212) 214-0455
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R016606-1 NY Primary

Addresses

Primary practice location

853 Broadway
Suite 1608
New York, NY 10003-4703

Mailing address

17 Lowerre PL
Valley Cottage, NY 10989-2322
Phone (917) 903-9665

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111108000339 NY Practitioner - Clinical Social Worker 6002089075 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

853 Broadway
Suite 1608
New York, NY 10003-4714
Phone (212) 982-8835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R016606-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881617264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LOWERRE PL",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892322",
            "telephone_number": "917-903-9665",
            "fax_number": "212-214-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 BROADWAY",
            "address_2": "SUITE 1608",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034703",
            "telephone_number": "212-982-8835",
            "fax_number": "212-214-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINGORTEN",
        "first_name": "JUDITH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R016606-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.