Individual provider Active NPI

Freddy Baez, L.C.S.W.-R

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1972836930
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
041291 Issued in NY
Practice address
1505 Pelham Pkwy N
1 Floor
Bronx, NY 10469-5912
Phone
(917) 685-1846
NPI assigned
Sep 9, 2009
Last updated
Dec 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X NU
Clinical Social Worker 1041C0700X 041291 NY Primary

Addresses

Primary practice location

1505 Pelham Pkwy N
1 Floor
Bronx, NY 10469-5912

Mailing address

1505 Pelham Pkwy N
1 Floor
Bronx, NY 10469-5912
Phone (917) 685-1846

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
I20111213000296 NY Practitioner - Clinical Social Worker 7416122841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 1989
Medicare assignment
May accept Medicare assignment
Group practices
New York Psychotherapy and Counseling CenterGroup PAC ID 4880600147, 113 clinicians

Practice addresses (Care Compare)

14040 Sanford Ave
Flushing, NY 11355-2556
Phone (718) 939-7160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York Psychotherapy and Counseling Center CurrentSince Dec 11, 2014 Accepting new patients
Montefiore Medical Center Past Accepting new patients
Coordinated Behavioral Care Ipa Inc Past Accepting new patients

Locations

579 Courtlandt Ave
Bronx, NY 10451
Phone (718) 908-8000

2857 Linden Blvd
Brooklyn, NY 11208
Phone (718) 235-3100

17620 148th Ave
Jamaica, NY 11434
Phone (718) 553-1100

Organizations & group practices 3

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": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1972836930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 PELHAM PKWY N",
            "address_2": "1 FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695912",
            "telephone_number": "917-685-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 PELHAM PKWY N",
            "address_2": "1 FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695912",
            "telephone_number": "917-685-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZ",
        "first_name": "FREDDY",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "041291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.