Individual provider Active NPI

Jessica A Glass, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1992857171
Registry record updated Apr 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0727141 Issued in NY
Practice address
134 N 4TH St
Brooklyn, NY 11249-3296
Phone
(917) 701-6297
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2024

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 0727141 NY Primary

Addresses

Primary practice location

134 N 4TH St
Brooklyn, NY 11249-3296

Mailing address

134 N 4TH St
Brooklyn, NY 11249-3296
Phone (646) 450-7748

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
I20070212000635 NY Practitioner - Clinical Social Worker 0648272187 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valera Medical PCGroup PAC ID 0547690521, 160 clinicians

Practice addresses (Care Compare)

134 N 4TH St
Brooklyn, NY 11249-3296
Phone (646) 450-7748

139 Centre St
Suite 824
New York, NY 10013-4558
Phone (646) 450-7748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
072714NYMDClinical Social Worker
0727141NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Valera Medical, P.C. Clinical CurrentSince Aug 25, 2023 Accepting new patients
The Fortune Society Inc. Clinical CurrentSince Nov 15, 2015 Accepting new patients
Sun River Health Inc. CurrentSince Jul 15, 2019 Accepting new patients
Sun River Health Inc Current Accepting new patients
Catholic Charities Neigborhood Services Clinical Past Accepting new patients
The Fortune Society PastSince Sep 5, 2021 Accepting new patients
Catholic Charities Neighborhood Services, Inc. Past Accepting new patients
Transitional Services for New York,Inc. Past Accepting new patients
Transitional Services for New York, Inc PastSince Aug 11, 2009 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

134 N 4th St
Brooklyn, NY 11249

803 Sterling Pl
Brooklyn, NY 11216
Phone (718) 613-1700

2976 Northern Blvd
Long Island City, NY 11101
Phone (212) 691-7554

2976 Northern Blvd
Fl 2
Long Island City, NY 11101
Phone (212) 691-7554

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712448000000",
    "number": "1992857171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 N 4TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112493296",
            "telephone_number": "646-450-7748",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 N 4TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112493296",
            "telephone_number": "917-701-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2024-04-07",
        "certification_date": "2024-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0727141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.