Individual provider Active NPI

Jane Gold, LCSW

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1922184365
Registry record updated Aug 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R036614-1 Issued in NY
Practice address
2500 Johnson Ave
Apt 14E
Bronx, NY 10463-4933
Phone
(917) 991-1672
NPI assigned
Oct 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2020

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 R036614-1 NY Primary

Addresses

Primary practice location

2500 Johnson Ave
Apt 14E
Bronx, NY 10463-4933

Mailing address

15 W 84TH St
1F
New York, NY 10024-4703
Phone (718) 601-9892

Other identifiers 1

IdentifierTypeStateIssuer
RO36614-1OtherNYLICENSE

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
I20040419000653 NY Practitioner - Clinical Social Worker 5193710150 Practice locations: Bronx, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2500 Johnson Ave
Apt 14E
Bronx, NY 10463-4933
Phone (917) 991-1672

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R036614-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598659200000",
    "number": "1922184365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W 84TH ST",
            "address_2": "1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244703",
            "telephone_number": "718-601-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 JOHNSON AVE",
            "address_2": "APT 14E",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104634933",
            "telephone_number": "917-991-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "JANE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-28",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R036614-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RO36614-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.