Individual provider Active NPI

Beth Tipperman, L.C.S.W.

  • Clinical Social Worker
  • East Northport, NY
National Provider Identifier
1013151380
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR018735-1 Issued in NY
Practice address
554 Larkfield Rd
East Northport, NY 11731-4205
Phone
(516) 594-0247
Fax
(718) 830-9088
NPI assigned
Apr 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

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 PR018735-1 NY Primary

Addresses

Primary practice location

554 Larkfield Rd
East Northport, NY 11731-4205

Mailing address

554 Larkfield Rd
East Northport, NY 11731-4205
Phone (516) 594-0247

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
I20090923000351 NY Practitioner - Clinical Social Worker 5890841464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Perelman School of Med at the University of Pennsylvania, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samuel Field YmandywhaGroup PAC ID 9537154638, 18 clinicians

Practice addresses (Care Compare)

5928 Little Neck Pkwy
Little Neck, NY 11362-2532
Phone (718) 224-0566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR018735-1NYMDClinical Social Worker
018735NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel Field Ym&Ywha CurrentSince Aug 31, 2009 Accepting new patients
Karat Health, Inc. PastSince Aug 31, 2009 Accepting new patients
United Cerebral Palsy Assoc of Nys Inc. Past Accepting new patients

Locations

5928 Little Neck Pkwy
Little Neck, NY 11362
Phone (347) 306-0767

5820 Little Neck Pkwy
Little Neck, NY 11362
Phone 64651875842001

Organizations & group practices 3

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": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240963200000",
    "number": "1013151380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 LARKFIELD RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117314205",
            "telephone_number": "516-594-0247",
            "fax_number": "718-830-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 LARKFIELD RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117314205",
            "telephone_number": "516-594-0247",
            "fax_number": "718-830-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPPERMAN",
        "first_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2009-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR018735-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

Verify at the official NPI Registry.