Individual provider Active NPI

David A Cannucciari, LCSW

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1063746261
Registry record updated Sep 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R029803 Issued in NY
Practice address
600 E Genesee St
Suite 217
Syracuse, NY 13202-2100
Phone
(315) 422-0300
Fax
(315) 479-8455
NPI assigned
Sep 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2009

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 R029803 NY Primary

Addresses

Primary practice location

600 E Genesee St
Suite 217
Syracuse, NY 13202-2100

Mailing address

600 E Genesee St
Suite 217
Syracuse, NY 13202-2100
Phone (315) 422-0300

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
I20091201000537 NY Practitioner - Clinical Social Worker 9335288539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatry Services of New York, PCGroup PAC ID 9133534340, 34 clinicians

Practice addresses (Care Compare)

3300 James St
Suite 100
Syracuse, NY 13206-2392
Phone (315) 422-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R029803NYMDClinical Social Worker
029803NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatry Services of New York PC CurrentSince Feb 20, 2024 Accepting new patients
Psychological Healthcare, PLLC CurrentSince Sep 11, 2011 Accepting new patients
Psychiatry Services of New York, P.C. Clinical CurrentSince Feb 20, 2024 Accepting new patients

Locations

8289 Loop Rd
Baldwinsville, NY 13027
Phone (315) 452-0300

600 E Genesee St
Ste 217
Syracuse, NY 13202
Phone (315) 452-0300

3300 James St
Ste 100
Syracuse, NY 13206

3300 James St
Ste 201
Syracuse, NY 13206
Phone (315) 437-4500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28623/brand/6/csg/1/fhir/r4

Organizations & group practices 3

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": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253577600000",
    "number": "1063746261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E GENESEE ST",
            "address_2": "SUITE 217",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022100",
            "telephone_number": "315-422-0300",
            "fax_number": "315-479-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E GENESEE ST",
            "address_2": "SUITE 217",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022100",
            "telephone_number": "315-422-0300",
            "fax_number": "315-479-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNUCCIARI",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-22",
        "last_updated": "2009-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R029803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.