Jennifer Soohoo-Tibaldi

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

069373 Issued in NY

Practice address

462 1St Ave RM 21S38
New York, NY 10016-9196

Phone

(212) 562-6035

Fax

(212) 263-0202

NPI assigned

Aug 11, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1972989101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 JENKINS ST",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115661758",
            "telephone_number": "212-562-6035",
            "fax_number": "212-263-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE RM 21S38",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-6035",
            "fax_number": "212-263-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOOHOO-TIBALDI",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sahil Sood, MD
• Shallini Sood, M.D.
• Sunir Tony Sood, DPT
• Tara Raviprakash Sood, M.D.
• Vandana Sood
• Jane Soohoo, M.D.
• Robert David Soohoo, PA
• Carmen E Sookhdeo, AGNP-C, RN, OCN
• Ernesto Sookhoo, PA
• Sarita Sooklal, MD

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.