Justin Patrick Walck

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

405 Bewley Building
Lockport, NY 14094-2934

Phone

(716) 531-8433

NPI assigned

May 22, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Matthew H Davis LCSW PLLCGroup PAC ID 9335566595, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Matthew H Davis LCSW, PLLC

  • Clinical Social Worker
  • Buffalo, NY
  • NPI 1700404621
  Medicare reassignment Care Compare group NPD
• Walck Practical Therapy

  • Adult Mental Health Clinic/Center
  • Lockport, NY
  • NPI 1841972585
  NPD Authorized official

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1063858660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5104 CARRIAGE LN STE 200",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140949747",
            "telephone_number": "716-531-8433",
            "fax_number": "716-819-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 BEWLEY BUILDING",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140942934",
            "telephone_number": "716-531-8433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 Sylvan Pkwy",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142281109",
            "country_code": "US",
            "telephone_number": "716-531-8433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALCK",
        "first_name": "JUSTIN",
        "middle_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-22",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donnie R Waits, LPN, PDN, A.S.
• Victoria M Waits
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walck Practical Therapy
• Walgreen Eastern Co Inc
• Madonna E Walker
• Stephanie Lynn Walker
• Kimberly Anne Walp, LPN
• Connor Walters

• Social Worker in Lockport, NY
• Providers in Lockport, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.