Individual provider Active NPI

Maxwell Rosenberg, LMSW

  • Social Worker
  • Bronx, NY
National Provider Identifier
1912386772
Registry record updated May 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1894 WALTON AVE Issued in NY
Practice address
1894 Walton Ave
Bronx, NY 10453-6018
Phone
(718) 583-3060
NPI assigned
May 27, 2015
Last updated
May 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1894 WALTON AVE NY Primary

Addresses

Primary practice location

1894 Walton Ave
Bronx, NY 10453-6018

Mailing address

1894 Walton Avenue
Bronx, NY 10453
Phone (718) 583-3060

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
I20180419000216 NY Practitioner - Clinical Social Worker 6305109653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1623 Kings Hwy
Brooklyn, NY 11229-1209
Phone 9292737601426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1894 WALTON AVENYMDSocial Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1912386772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1894 WALTON AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10453",
            "telephone_number": "718-583-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1894 WALTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104536018",
            "telephone_number": "718-583-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "MAXWELL",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "1894 WALTON AVE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.