Individual provider Active NPI

Daniel Hershkovich

  • Clinical Social Worker
  • Monsey, NY
National Provider Identifier
1972196210
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090850-01 Issued in NY
Practice address
25 Robert Pitt Dr
Monsey, NY 10952-3365
Phone
(845) 425-5252
NPI assigned
Feb 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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 090850-01 NY Primary

Addresses

Primary practice location

25 Robert Pitt Dr
Monsey, NY 10952-3365

Mailing address

43 Rena LN
Lakewood, NJ 08701-5267
Phone (718) 541-0048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20260402000820 NJ Practitioner - Clinical Social Worker 7911482401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakewood Community Services Corp.Group PAC ID 3274952114, 9 clinicians

Practice addresses (Care Compare)

500 W Kennedy Blvd
Lakewood, NJ 08701-1254
Phone (732) 886-6964

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
090850-01NYMDClinical Social 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": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1972196210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 RENA LN",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015267",
            "telephone_number": "718-541-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ROBERT PITT DR",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109523365",
            "telephone_number": "845-425-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSHKOVICH",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090850-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monsey, NY

Sources for this page

Verify at the official NPI Registry.