Individual provider Active NPI

Patricia Masterson-Kane, LCSW, ACSW, MSW

  • Clinical Social Worker
  • Franklin Lakes, NJ
National Provider Identifier
1043345440
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC01300200 Issued in NJ
Practice address
653 Shawnee Dr
Franklin Lakes, NJ 07417-1023
Phone
(201) 612-6696
Fax
(201) 612-6696
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 44SC01300200 NJ Primary
Clinical Social Worker 1041C0700X R0320571 NY

Addresses

Primary practice location

653 Shawnee Dr
Franklin Lakes, NJ 07417-1023

Mailing address

34 Amherst CT
Glen Rock, NJ 07452-1302
Phone (201) 612-6696

Other names 1

  • Patricia Mary Masterson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20041124000666 NJ Practitioner - Clinical Social Worker 7618932096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

36 Faner Rd
Midland Park, NJ 07432-1719
Phone (201) 493-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC01300200NJMDClinical Social Worker
R0320571NYMDClinical Social Worker

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043345440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 AMHERST CT",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521302",
            "telephone_number": "201-612-6696",
            "fax_number": "201-612-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 SHAWNEE DR",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171023",
            "telephone_number": "201-612-6696",
            "fax_number": "201-612-6696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERSON-KANE",
        "first_name": "PATRICIA",
        "credential": "LCSW,  ACSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC01300200",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0320571",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "MASTERSON",
            "middle_name": "MARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Franklin Lakes, NJ

Sources for this page

Verify at the official NPI Registry.