Active NPI
Richeal Bruce
- Clinical Social Worker
- Far Rockaway, NY
National Provider Identifier
1902569049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 114258
- Practice address
- 11508 Rockaway Beach Blvd
Far Rockaway, NY 11694-2322 - Phone
- (718) 554-7766
- NPI assigned
- Oct 15, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 114258 | NY | Primary |
Addresses
Primary practice location
11508 Rockaway Beach Blvd
Far Rockaway, NY 11694-2322
Mailing address
1270 New York Ave Apt 3a
Brooklyn, NY 11203-5555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
8095 Innovation Park Dr
BLDG C
Fairfax, VA 22031-4868
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114258 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634256000000",
"number": "1902569049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1270 NEW YORK AVE APT 3A",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112035555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11508 ROCKAWAY BEACH BLVD",
"city": "FAR ROCKAWAY",
"state": "NY",
"postal_code": "116942322",
"telephone_number": "718-554-7766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCE",
"first_name": "RICHEAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-15",
"last_updated": "2021-10-15",
"certification_date": "2021-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "114258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Far Rockaway, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.