Individual provider Active NPI

John Dillon, CSW

  • Clinical Social Worker
  • Garden City, NY
National Provider Identifier
1023139300
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R053490-1 Issued in NY
Practice address
385 Oak Street
Garden City, NY 11530
Phone
(516) 705-3400
NPI assigned
Apr 3, 2007
Last updated
Apr 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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 R053490-1 NY Primary

Addresses

Primary practice location

385 Oak Street
Garden City, NY 11530

Mailing address

971 Brent Dr
Wantagh, NY 11793-1042
Phone (516) 429-2720

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
I20070607000024 NY Practitioner - Clinical Social Worker 8527166248 Reassigns benefits to 1 organization
Practice locations: Wantagh, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R053490-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center CurrentSince Jun 30, 2006 Accepting new patients
Mercy Medical Center CurrentSince Jun 30, 2006 Accepting new patients
Mercy Medical Center Current Accepting new patients
Southwest Suffolk Medical PC Past Accepting new patients

Locations

385 Oak St
Garden City, NY 11530
Phone (516) 705-3400

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427846400000",
    "number": "1023139300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 BRENT DR",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117931042",
            "telephone_number": "516-429-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 OAK STREET",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-705-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "JOHN",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2015-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R053490-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.