Individual provider Active NPI

Kathleen Anne Riley-Tryon, LCSW

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1093809204
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
069916-1 Issued in NY
Practice address
530 Oak St
Syracuse, NY 13203-1652
Phone
(315) 436-5428
Fax
(315) 422-2022
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

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 069916-1 NY Primary

Addresses

Primary practice location

530 Oak St
Syracuse, NY 13203-1652

Mailing address

622 Dewitt St
Syracuse, NY 13203-1345
Phone (315) 436-5428

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
I20040220000118 NY Practitioner - Clinical Social Worker 4789579418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harmony HealingGroup PAC ID 0840236055, 2 clinicians

Practice addresses (Care Compare)

306 Highland Ave
Syracuse, NY 13203-1608
Phone (315) 436-5428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
069916-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Healing CurrentSince May 19, 2005 Accepting new patients
Psychological & Family Services Past Accepting new patients

Locations

530 Oak St
Syracuse, NY 13203
Phone (315) 436-5428

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093809204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 DEWITT ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031345",
            "telephone_number": "315-436-5428",
            "fax_number": "315-422-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 OAK ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031652",
            "telephone_number": "315-436-5428",
            "fax_number": "315-422-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY-TRYON",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069916-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.