Individual provider Active NPI

Ronald Pollock, L.C.S.W.

  • Clinical Social Worker
  • Smithtown, NY
National Provider Identifier
1043375736
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR018448-1 Issued in NY
Practice address
5 Dorchester Rd
Smithtown, NY 11787-5402
Phone
(631) 360-1414
Fax
(631) 360-1414
NPI assigned
Dec 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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 PR018448-1 NY Primary

Addresses

Primary practice location

5 Dorchester Rd
Smithtown, NY 11787-5402

Mailing address

5 Dorchester Rd
Smithtown, NY 11787-5402
Phone (631) 360-1414

Other identifiers 3

IdentifierTypeStateIssuer
A129875OtherNYVALUE OPTIONS NATIONAL #
075649OtherNYVALUE OPTIONS
0075398OtherNYGHI ID #

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
I20100301000236 NY Practitioner - Clinical Social Worker 7618012709 Practice locations: Smithtown, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5 Dorchester Rd
Smithtown, NY 11787-5402
Phone (631) 360-1414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR018448-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1167004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1043375736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DORCHESTER RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875402",
            "telephone_number": "631-360-1414",
            "fax_number": "631-360-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DORCHESTER RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875402",
            "telephone_number": "631-360-1414",
            "fax_number": "631-360-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "RONALD",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-25",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR018448-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS NATIONAL #",
            "identifier": "A129875",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "075649",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI ID #",
            "identifier": "0075398",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.