MS. ELAINE M EDELMAN LCSW
NPI 1225214265
Social Worker - Clinical in E. Brunswick, NJ
NPI Status: Active since January 20, 2008
Contact Information
224 ROUTE 18 NORTH
E. BRUNSWICK, NJ
ZIP 08816
Phone: (917) 494-1617
- Individual
- Female
- Years of Experience 38
- Social Worker
- Clinical
- PECOS Enrolled
- Accepts Medicare Approved Payment
About ELAINE EDELMAN
Elaine Edelman is a provider established in E. Brunswick, New Jersey and her medical specialization is Social Worker with a focus in clinical with more than 38 years of experience. She graduated from Oakland College Of Medicine And Surgery in 1986. The healthcare provider is registered in the NPI registry with number 1225214265 assigned on January 2008. The practitioner's primary taxonomy code is 1041C0700X with license number 44SC01173300 (NJ). The provider is registered as an individual and her NPI record was last updated 11 years ago.
- NPI
- 1225214265
- Provider Name
- MS. ELAINE M EDELMAN LCSW
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 224 ROUTE 18 NORTH E. BRUNSWICK, NJ 08816
- Location Phone
- (917) 494-1617
- Mailing Address
- 5 RICHARD RD. E. BRUNSWICK, NJ 08816
- Mailing Phone
- (917) 494-1617
- Medical School Name
- OAKLAND COLLEGE OF MEDICINE AND SURGERY
- Graduation Year
- 1986
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 01-20-2008
- Last Update Date
- 02-15-2013
- Code Navigator
A clinical social worker like Elaine Edelman is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.
Elaine Edelman is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Social Worker Clinical
- Taxonomy Code
- 1041C0700X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 44SC01173300
- License State
- NJ
- Taxonomy Description
- A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Medicare
Medicaid
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| N51711 | MEDICARE PIN (08) |
PECOS Enrollment and Medicare Participation Status
Elaine Edelman is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 3375615636
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20080701000340
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 2 | 5 | 2 | 1 | 4 | 2 | 6 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 4 | 5 | 4 | 1 | 8 | 2 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 4 + 5 + 4 + 1 + 8 + 2 + 1 + 2 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1225214265 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1225214265, enumerated in the NPI registry as an "individual" on January 20, 2008
The provider is located at 224 Route 18 North E. Brunswick, Nj 08816 and the phone number is (917) 494-1617
The provider's speciality is Social Worker with taxonomy code 1041C0700X with a focus in Clinical
The provider has more than 38 years of experience. She graduated from Oakland College Of Medicine And Surgery in 1986.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of May 03, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
This NPI record was last updated on January 20, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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