Individual provider Active NPI

Tshiyamba Yvette Katende, LMSW

  • Social Worker
  • Bronx, NY
National Provider Identifier
1942767983
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
105162 Issued in NY
Practice address
30 E Clarke PL Apt 4a
Bronx, NY 10452-7508
Phone
(917) 209-1375
NPI assigned
Feb 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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 105162 NY Primary

Addresses

Primary practice location

30 E Clarke PL Apt 4a
Bronx, NY 10452-7508

Mailing address

30 E Clarke PL Apt 4a
Bronx, NY 10452-7508
Phone (917) 209-1375

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
I20260604001529 NY Practitioner - Clinical Social Worker 0840761425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Care Therapy LCSW of New York PLLCGroup PAC ID 7113269010, 63 clinicians

Practice addresses (Care Compare)

14415 68TH Rd
Flushing, NY 11367-1330
Phone (973) 264-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105162NYMDSocial 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1942767983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E CLARKE PL APT 4A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104527508",
            "telephone_number": "917-209-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E CLARKE PL APT 4A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104527508",
            "telephone_number": "917-209-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATENDE",
        "first_name": "TSHIYAMBA",
        "middle_name": "YVETTE",
        "name_prefix": "Miss",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "105162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.