Individual provider Active NPI

Ingrid Sharon Nunez, LCSW-R

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1992136501
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
085545-1 Issued in NY
Practice address
3265 Johnson Ave Ste 100
Bronx, NY 10463-3539
Phone
(646) 204-6755
Fax
(646) 893-7767
NPI assigned
Dec 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 087769-1 NY
Clinical Social Worker 1041C0700X 085545-1 NY Primary

Addresses

Primary practice location

3265 Johnson Ave Ste 100
Bronx, NY 10463-3539

Mailing address

3265 Johnson Ave Ste 100
Bronx, NY 10463-3539
Phone (917) 587-4819

Other practice location 1

3265 Johnson Ave Ste 100
Bronx, NY 10463-3539
Phone (646) 204-6755

Other identifiers 1

IdentifierTypeStateIssuer
05850977MedicaidNY

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
I20171102002400 NY Practitioner - Clinical Social Worker 6901162262 Practice locations: Bronx, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3265 Johnson Ave
Bronx, NY 10463-3539
Phone (917) 587-4819

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
087769-1NYMDSocial Worker
085545-1NYMDClinical Social Worker

Networks

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

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1992136501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3265 JOHNSON AVE STE 100",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104633539",
            "telephone_number": "917-587-4819",
            "fax_number": "646-893-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3265 JOHNSON AVE STE 100",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104633539",
            "telephone_number": "646-204-6755",
            "fax_number": "646-893-7767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3265 Johnson Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104633539",
            "country_code": "US",
            "telephone_number": "646-204-6755",
            "fax_number": "646-893-7767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUNEZ",
        "first_name": "INGRID",
        "middle_name": "SHARON",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-06",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "087769-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085545-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05850977",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.