Individual provider Active NPI

Jason M. Diaz, LCSW

  • Clinical Social Worker
  • Binghamton, NY
National Provider Identifier
1891915161
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
077901 Issued in NY
Practice address
38 Riverside Dr
3Rd Floor
Binghamton, NY 13905-4596
Phone
(607) 765-2282
NPI assigned
Apr 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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 077901 NY Primary

Addresses

Primary practice location

38 Riverside Dr
3Rd Floor
Binghamton, NY 13905-4596

Mailing address

38 Riverside Dr
3Rd Floor
Binghamton, NY 13905-4596
Phone (607) 765-2282

Other identifiers 1

IdentifierTypeStateIssuer
00618162MedicaidNY

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
I20120504000397 NY Practitioner - Clinical Social Worker 9931384229 Reassigns benefits to 1 organization
Practice locations: Endicott, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Che Senior Psychological Services, PCGroup PAC ID 8022905314, 227 clinicians

Practice addresses (Care Compare)

4988 State Hwy 30
Amsterdam, NY 12010-7520
Phone (800) 275-3243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077901NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical CurrentSince Mar 4, 2015 Accepting new patients

Locations

4988 State Highway 30
Amsterdam, NY 12010
Phone (518) 842-3100

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": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1891915161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 RIVERSIDE DR",
            "address_2": "3RD FLOOR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054596",
            "telephone_number": "607-765-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 RIVERSIDE DR",
            "address_2": "3RD FLOOR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054596",
            "telephone_number": "607-765-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JASON",
        "middle_name": "M.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-27",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00618162",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.