Individual provider Active NPI

Tammy L Tombroff, LCSW

  • Clinical Social Worker
  • St Augustine, FL
National Provider Identifier
1972640985
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7218 Issued in FL
Practice address
3013 1St St
St Augustine, FL 32084-2268
Phone
(904) 321-6049
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW7218 FL
Clinical Social Worker 1041C0700X 7218 FL Primary

Addresses

Primary practice location

3013 1St St
St Augustine, FL 32084-2268

Mailing address

3013 First Street
St Augustine, FL 32084
Phone (904) 829-3097

Other identifiers 4

IdentifierTypeStateIssuer
11359410OtherFLCAQH
270801OtherFLCOMPSYCH
2273051OtherFLFIRST HEALTH CNN
Z072GOtherFLBCBS

Other names 1

  • Mrs. Tammy L Tombroff Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20041008000838 FL Practitioner - Clinical Social Worker 0648239186 Practice locations: St Augustine, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2200 N Ponce de Leon Blvd
Suite 3
St Augustine, FL 32084-2650
Phone (904) 321-6049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7218FLMDClinical Social Worker
SW7218FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1972640985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3013 FIRST STREET",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "32084",
            "telephone_number": "904-829-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3013 1ST ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842268",
            "telephone_number": "904-321-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMBROFF",
        "first_name": "TAMMY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7218",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "7218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11359410",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "270801",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH CNN",
            "identifier": "2273051",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Z072G",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "TOMBROFF",
            "middle_name": "L",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.