Agnelo B Dias, ED. D., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

73 079925 Issued in NY

Practice address

2174 Hewlett Ave
Suite 212
Merrick, NY 11566-3606

Phone

(516) 513-2678

Fax

(516) 414-1953

NPI assigned

May 3, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Long Island Psychiatric Services PCGroup PAC ID 8820271125, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Long Island Psychiatric Services P.C.

  • Psychiatry Physician
  • Baldwin, NY
  • NPI 1821305368
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1013139716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 DOGWOOD AVE",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115523128",
            "telephone_number": "516-414-1953",
            "fax_number": "516-414-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2174 HEWLETT AVE",
            "address_2": "SUITE 212",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115663606",
            "telephone_number": "516-513-2678",
            "fax_number": "516-414-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAS",
        "first_name": "AGNELO",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "ED. D., LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73 079925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Sullivan Dennis, PHD, LCSW
• Tamesha Dennis
• Nadine L Derovira
• Designing Dental Smiles, PLLC
• Mariel Brooke Deutsch, MD, FAAN
• Amanda Dias
• Christian Matthew Diconsiglio, LMSW, CASAC-T
• Distinctive Physical Therapy PLLC
• Frauke Dittel
• Doctors Medical Office PLLC

• Clinical Social Worker in Merrick, NY
• Providers in Merrick, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.