Individual provider Active NPI

Diane Boar, MSW, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1902984040
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
83808 Issued in NY
Practice address
33 W End Ave Apt 3G
New York, NY 10023-7810
Phone
(908) 616-5550
Fax
(732) 264-0076
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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 83808 NY Primary

Addresses

Primary practice location

33 W End Ave Apt 3G
New York, NY 10023-7810

Mailing address

33 W End Ave Apt 3G
New York, NY 10023-7810
Phone (908) 616-5550

Other identifiers 1

IdentifierTypeStateIssuer
83808OtherNYLICENSE

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
I20180511002040 NY Practitioner - Clinical Social Worker 8628067626 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

33 W End Ave
Apt 3G
New York, NY 10023-7810
Phone (908) 616-5550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
83808NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1902984040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 W END AVE APT 3G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237810",
            "telephone_number": "908-616-5550",
            "fax_number": "347-778-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W END AVE APT 3G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237810",
            "telephone_number": "908-616-5550",
            "fax_number": "732-264-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAR",
        "first_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "83808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "83808",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.