Individual provider Active NPI

Robert Joseph Foresti, LCSW

  • Clinical Social Worker
  • Camillus, NY
National Provider Identifier
1003925165
Registry record updated May 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
063965-1 Issued in NY
Practice address
4914 W Genesee St
Camillus, NY 13031-2374
Phone
(315) 636-0120
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2020

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 063965-1 NY Primary

Addresses

Primary practice location

4914 W Genesee St
Camillus, NY 13031-2374

Mailing address

4914 W Genesee St
Camillus, NY 13031-2374
Phone (315) 636-0120

Other practice location 1

146 North St
Auburn, NY 13021-1831
Phone (315) 253-2746

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
I20070711000517 NY Practitioner - Clinical Social Worker 4486754033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4914 W Genesee St
Camillus, NY 13031-2374
Phone (315) 636-0120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
063965-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Healthcare, PLLC CurrentSince Feb 8, 2010 Accepting new patients
Robert J. Foresti, LCSW, PLLC Clinical CurrentSince Jun 1, 2020 Accepting new patients

Locations

8289 Loop Rd
Baldwinsville, NY 13027
Phone (315) 452-0300

4914 W Genesee St
Camillus, NY 13031
Phone (315) 446-1435

3300 James St
Ste 100
Syracuse, NY 13206

Organizations & group practices 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590278400000",
    "number": "1003925165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4914 W GENESEE ST",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130312374",
            "telephone_number": "315-636-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4914 W GENESEE ST",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130312374",
            "telephone_number": "315-636-0120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "146 North St",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "NY",
            "postal_code": "130211831",
            "country_code": "US",
            "telephone_number": "315-253-2746",
            "fax_number": "315-253-1077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORESTI",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-05-24",
        "certification_date": "2020-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "063965-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camillus, NY

Sources for this page

Verify at the official NPI Registry.