Individual provider Active NPI

Maria Sofia Panitsidis, LCSW

  • Clinical Social Worker
  • Rochester, NY
National Provider Identifier
1013368513
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
087650 Issued in NY
Practice address
360 East Avenue
Rochester, NY 14604
Phone
(585) 287-9523
NPI assigned
Jun 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 093735 NY
Clinical Social Worker 1041C0700X 087650 NY Primary

Addresses

Primary practice location

360 East Avenue
Rochester, NY 14604

Mailing address

1350 Buffalo Rd Ste 18
Rochester, NY 14624-1856
Phone (585) 730-1506

Other practice location 1

1350 Buffalo Rd Ste 18
Rochester, NY 14624-1856
Phone (585) 730-1506

Other identifiers 1

IdentifierTypeStateIssuer
06000215MedicaidNY

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
I20200421000888 NY Practitioner - Clinical Social Worker 4486084183 Reassigns benefits to 1 organization
Practice locations: Rochester, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Huther-Doyle Memorial Institute IncGroup PAC ID 2264675784, 5 clinicians

Practice addresses (Care Compare)

360 E Ave
Rochester, NY 14604-2638
Phone (585) 325-5100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
087650NYMDClinical Social Worker
093735NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life Strategies Counseling Services LCSW PLLC Clinical CurrentSince Apr 16, 2023 Accepting new patients
Huther-Doyle Memorial Institute Inc CurrentSince May 21, 2023 Accepting new patients
Huther Doyle Memorial Institute PastSince Nov 13, 2022 Accepting new patients

Locations

360 East Ave
Rochester, NY 14604
Phone (585) 325-5100

1350 Buffalo Rd
Ste 18
Rochester, NY 14624
Phone (585) 290-2224

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": "1466899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1013368513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 BUFFALO RD STE 18",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241856",
            "telephone_number": "585-730-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 EAST AVENUE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14604",
            "telephone_number": "585-287-9523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Buffalo Rd Ste 18",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146241856",
            "country_code": "US",
            "telephone_number": "585-730-1506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANITSIDIS",
        "first_name": "MARIA",
        "middle_name": "SOFIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-26",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093735",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06000215",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.