Individual provider Active NPI

Ilene A Brickley, LMSW

  • Social Worker
  • Smithtown, NY
National Provider Identifier
1023255866
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
075188 Issued in NY
Practice address
363 Route 111
Suite 103
Smithtown, NY 11787-4756
Phone
(631) 265-3133
Fax
(631) 265-3205
NPI assigned
Jan 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 075188 NY Primary

Addresses

Primary practice location

363 Route 111
Suite 103
Smithtown, NY 11787-4756

Mailing address

363 Route 111
103
Smithtown, NY 11787-4756
Phone (631) 265-3133

Other names 1

  • Mrs. Ilene A Brickley Other name

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
I20210406000227 NY Practitioner - Clinical Social Worker 6507273745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Stony Brook, School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

565 Route 25a
Suite LR5
Miller Place, NY 11764-2666
Phone (631) 786-1565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
075188NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ilene a. Brickley, PLLC Social Worker CurrentSince Jan 1, 2021 Accepting new patients

Locations

565 Route 25A
Ste LR5
Miller Place, NY 11764
Phone (631) 786-1565

Organizations & group practices 1

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": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231977600000",
    "number": "1023255866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 ROUTE 111",
            "address_2": "103",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874756",
            "telephone_number": "631-265-3133",
            "fax_number": "631-265-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 ROUTE 111",
            "address_2": "SUITE 103",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874756",
            "telephone_number": "631-265-3133",
            "fax_number": "631-265-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICKLEY",
        "first_name": "ILENE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-15",
        "last_updated": "2009-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "075188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILENE",
            "last_name": "BRICKLEY",
            "middle_name": "A",
            "prefix": "MRS.",
            "credential": "LMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.