Individual provider Active NPI

Vicki Diane Sunshine, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1053418491
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R045408-1 Issued in NY
Practice address
1670-78 E. 17TH St
3Rd Floor
Brooklyn, NY 11229-1258
Phone
(718) 375-1200
Fax
(718) 382-3358
NPI assigned
Sep 20, 2006
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R045408-1 NY Primary

Addresses

Primary practice location

1670-78 E. 17TH St
3Rd Floor
Brooklyn, NY 11229-1258

Mailing address

237 16TH St
Brooklyn, NY 11215-5414
Phone (718) 499-7814

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
I20120109000660 NY Practitioner - Clinical Social Worker 4688840978

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1623 Kings Hwy
Brooklyn, NY 11229-1209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R045408-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Interborough Developmental and Consultation Center Clinical Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/interborough/r4/

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053418491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 16TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155414",
            "telephone_number": "718-499-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670-78 E. 17TH ST",
            "address_2": "3RD FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291258",
            "telephone_number": "718-375-1200",
            "fax_number": "718-382-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNSHINE",
        "first_name": "VICKI",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R045408-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.