JACOB MERGENDOLLER LCSW
NPI 1962017715
Social Worker - Clinical in New York, NY

Q: What is Jacob Mergendoller's NPI number?

The NPI number for Jacob Mergendoller is 1962017715. It was assigned to this individual provider in the NPPES registry on September 9, 2020.

Q: What is Jacob Mergendoller's specialty?

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

Active since September 09, 2020PECOS Enrolled

276 5TH AVE RM 604, NEW YORK, NY 10001(415) 686-1385 Get Directions Write a Review

NPPES record last updated: March 20, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 20, 2025, Aug 13, 2021, Jul 26, 2021 and 1 more (4 updates tracked since 2020).

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About Jacob Mergendoller Lcsw NPPES

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

JACOB MERGENDOLLER LCSW (NPI 1962017715) is an individual clinical provider in New York, New York and active in the NPI registry since September 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962017715

Entity TypeIndividualMale

Primary Taxonomy1041C0700X

Provider Legal NameJACOB MERGENDOLLERCredential: LCSW

Location Address276 5TH AVE RM 604New York, NY 10001-4527

Mailing Address276 5th Ave Rm 604New York, NY 10001-4527 · (415) 686-1385

Phone(415) 686-1385

Sole ProprietorNo

Enumeration DateSeptember 9, 2020

Last NPPES UpdateMarch 20, 20254 updates tracked since enumeration

NPPES CertifiedMarch 20, 2025

✔ NPI 1962017715 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

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.

276 5TH AVE RM 604, New York, NY 10001

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Mergendoller Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10001 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 $65.69 – $198.19

Typical copayment $0.00 (range $16.42 – $49.54)

Most-billed visit code NA

Established Patient

$81.44 typical visit price

range $21.20 – $160.66

Typical copayment $20.36 (range $5.30 – $40.16)

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 14

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

DR. ERICA JAEIN LEE MD

Psychiatry & Neurology (Psychiatry)