Individual provider Active NPI

John J. Flynn, LCSWR

  • Clinical Social Worker
  • Cheektowaga, NY
National Provider Identifier
1053408807
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
038456-1 Issued in NY
Practice address
1526 Walden Avenue
Suite 400
Cheektowaga, NY 14225
Phone
(716) 895-6700
Fax
(716) 896-0318
NPI assigned
Oct 5, 2006
Last updated
Nov 25, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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 038456-1 NY Primary

Addresses

Primary practice location

1526 Walden Avenue
Suite 400
Cheektowaga, NY 14225

Mailing address

1526 Walden Avenue
Cheektowaga, NY 14225
Phone (716) 895-6700

Other identifiers 1

IdentifierTypeStateIssuer
038456-1OtherNYLCSW-R

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
I20110524000009 NY Practitioner - Clinical Social Worker 7618153859 Reassigns benefits to 1 organization
Practice locations: Tonawanda, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Buffalo School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mid-Erie Mental Health Services IncGroup PAC ID 5496707945, 33 clinicians

Practice addresses (Care Compare)

1526 Walden Ave
Suite 400
Cheektowaga, NY 14225-4985
Phone (716) 895-7167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038456-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Erie Mental Health Services Inc CurrentSince Aug 24, 2014 Accepting new patients
Mid-Erie Counseling and Treatment Services Past Accepting new patients

Locations

1526 Walden Ave
Ste 400
Cheektowaga, NY 14225
Phone (716) 895-7167

Organizations & group practices 2

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1053408807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 WALDEN AVENUE",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "14225",
            "telephone_number": "716-895-6700",
            "fax_number": "716-896-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 WALDEN AVENUE",
            "address_2": "SUITE 400",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "14225",
            "telephone_number": "716-895-6700",
            "fax_number": "716-896-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "JOHN",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "LCSWR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "038456-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW-R",
            "identifier": "038456-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

Verify at the official NPI Registry.