Individual provider Active NPI

Elissa Kirtzman, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1992076285
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO38671-1 Issued in NY
Practice address
275 W 96TH St
23D
New York, NY 10025-6200
Phone
(212) 222-0079
NPI assigned
Jan 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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 RO38671-1 NY Primary

Addresses

Primary practice location

275 W 96TH St
23D
New York, NY 10025-6200

Mailing address

275 W 96TH St
23D
New York, NY 10025-6200
Phone (212) 222-4356

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
I20150701001852 NY Order and Referring Only - Clinical Social Worker 9032421193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO38671-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1992076285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W 96TH ST",
            "address_2": "23D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256200",
            "telephone_number": "212-222-4356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W 96TH ST",
            "address_2": "23D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256200",
            "telephone_number": "212-222-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRTZMAN",
        "first_name": "ELISSA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO38671-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.