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TUSHARBALA SETHY
NPI 1578258679
Social Worker - Clinical in Paramus, NJ

Active since April 06, 2023PECOS Enrolled
11-13 SUNFLOWER AVE, SUITE 1020, PARAMUS, NJ 07652(973) 529-8913 Get Directions Write a Review

NPPES record last updated: October 31, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Tusharbala Sethy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TUSHARBALA SETHY (NPI 1578258679) is an individual clinical provider in Paramus, New Jersey, licensed in New Jersey (44SC06307700) and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Hamilton, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1578258679
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameTUSHARBALA SETHY
Location Address11-13 SUNFLOWER AVE, SUITE 1020Paramus, NJ 07652
Mailing AddressPo Box 748465Atlanta, GA 30374-8465 · (855) 284-7483
Phone(973) 529-8913
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateApril 6, 2023
Last NPPES UpdateOctober 31, 2024
NPPES CertifiedOctober 25, 2024
✔ NPI 1578258679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NJ · 44SC06307700
Definition
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.
Also ListedSocial WorkerTaxonomy 104100000X · License 44SL06084400 (NJ)
11-13 SUNFLOWER AVE, Paramus, NJ 07652
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Secondary Practice Location 1

Location 12083 Klockner RdHamilton, NJ 08690-3415 · Phone (609) 222-4902

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tusharbala Sethy is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6901343060
PECOS Enrollment IDI20240807000449
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Tusharbala Sethy reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mind Your Mind
61 mi
Mental Health (Including Community Mental Health Center)
2083 KLOCKNER RD
Hamilton, NJ 08690
  • Reassigned Medicare billing, New Jersey enrollment
  • 33 clinicians in this Medicare group
NPI 1053955096 (732) 580-9096
Thrive Counseling LLC
366 mi
Mental Health
1000 JEFFERSON ST STE 2C
Lynchburg, VA 24504
  • Reassigned Medicare billing, New Jersey enrollment
  • 138 clinicians in this Medicare group
NPI 1215181300 (855) 284-7483

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07652 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $63.84 – $190.92
Typical copayment $0.00 (range $15.96 – $47.73)
Most-billed visit code NA
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INADVANCE MEDICINE ASSOCIATES EAST
Community Health Worker
11-13 SUNFLOWER AVE
PARAMUS, NJ 07652
Bergen County (844) 358-8648
POSITIVE PERSPECTIVE THERAPY, LLC
Marriage & Family Therapist
11-13 SUNFLOWER AVE
PARAMUS, NJ 07652
Bergen County (201) 739-2216

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tusharbala Sethy's NPI number?

The NPI number for Tusharbala Sethy is 1578258679. It was assigned to this individual provider in the NPPES registry on April 6, 2023.

Where is Tusharbala Sethy located?

Tusharbala Sethy practices at 11-13 Sunflower Ave Suite 1020, Paramus, NJ 07652. The listed phone number is (973) 529-8913.

What is Tusharbala Sethy's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Tusharbala Sethy enrolled in Medicare?

Yes. Tusharbala Sethy is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Tusharbala Sethy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tusharbala Sethy reassigns Medicare benefits to 2 organizations: Mind Your Mind (Hamilton, NJ) and Thrive Counseling LLC (Lynchburg, VA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tusharbala Sethy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tusharbala Sethy accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Tusharbala Sethy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tusharbala Sethy was last updated on October 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.