Individual provider Active NPI

Ilyse C Schonfeld, LCSW-R

  • Clinical Social Worker
  • Merrick, NY
National Provider Identifier
1033358445
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R071558-1 Issued in NY
Practice address
31 Merrick Ave Ste 120
Merrick, NY 11566-3406
Phone
(516) 705-8020
Fax
(516) 705-8822
NPI assigned
Feb 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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 R071558-1 NY Primary

Addresses

Primary practice location

31 Merrick Ave Ste 120
Merrick, NY 11566-3406

Mailing address

31 Merrick Ave Ste 120
Merrick, NY 11566-3406
Phone (516) 705-8020

Other practice location 1

2277 Grand Ave
Baldwin, NY 11510-3148
Phone (516) 377-5400

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
I20090326000228 NY Practitioner - Clinical Social Worker 2860559465 Practice locations: Merrick, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

31 Merrick Ave
Suite 120
Merrick, NY 11566-3406
Phone (516) 815-2290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R071558-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Scott M. Schonfeld, DPM, P.C. CurrentSince Jun 22, 2021 Accepting new patients

Locations

31 Merrick Ave
Ste 120
Merrick, NY 11566
Phone (516) 705-8020

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": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1033358445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 MERRICK AVE STE 120",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115663406",
            "telephone_number": "516-705-8020",
            "fax_number": "516-705-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 MERRICK AVE STE 120",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115663406",
            "telephone_number": "516-705-8020",
            "fax_number": "516-705-8822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2277 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Baldwin",
            "state": "NY",
            "postal_code": "115103148",
            "country_code": "US",
            "telephone_number": "516-377-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHONFELD",
        "first_name": "ILYSE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-09",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R071558-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

Verify at the official NPI Registry.