Active NPI
Marie Mistretta, L.C.S.W.
- Clinical Social Worker
- Williston Park, NY
National Provider Identifier
1013036748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R016968
- Practice address
- 101 Hillside Ave
Suite 101
Williston Park, NY 11596-2347 - Phone
- (516) 248-4581
- Fax
- (516) 248-4581
- NPI assigned
- Mar 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R016968 | NY | Primary |
Addresses
Primary practice location
101 Hillside Ave
Suite 101
Williston Park, NY 11596-2347
Mailing address
101 Hillside Ave
Suite 101
Williston Park, NY 11596-2347
Phone (516) 248-4581
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P3637040 | Other | NY | OXFORD |
| 062688 | Other | NY | VALUE OPTIONS |
| NX4412 | Other | NY | BC BS EMPIRE NY |
| 7404230 | Other | NY | GHI NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2017 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R016968 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013036748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 HILLSIDE AVE",
"address_2": "SUITE 101",
"city": "WILLISTON PARK",
"state": "NY",
"postal_code": "115962347",
"telephone_number": "516-248-4581",
"fax_number": "516-248-4581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 HILLSIDE AVE",
"address_2": "SUITE 101",
"city": "WILLISTON PARK",
"state": "NY",
"postal_code": "115962347",
"telephone_number": "516-248-4581",
"fax_number": "516-248-4581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISTRETTA",
"first_name": "MARIE",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R016968",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P3637040",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "062688",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS EMPIRE NY",
"identifier": "NX4412",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI NY",
"identifier": "7404230",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williston Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.