Nina Statman, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

094010-1 Issued in NY

Practice address

6209 16TH Ave
Brooklyn, NY 11204-2702

Phone

(718) 234-0073

NPI assigned

Mar 10, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MA2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

One Medstar Primary Care LLCGroup PAC ID 0749607307, 140 clinicians

Mass General Brigham Community Physicians IncGroup PAC ID 1759273436, 430 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mass General Brigham Community Physicians Inc.

  • Internal Medicine Physician
  • Haverhill, MA
  • NPI 1891112637
  Medicare reassignment Care Compare group NPD
• One Medstar Primary Care LLC

  • Family Medicine Physician
  • Washington, DC
  • NPI 1417571530
  Medicare reassignment Care Compare group
• Mass General Brigham Community Physicians Inc

  • Cardiovascular Disease Physician
  • Medford, MA
  • NPI 1548638265
  NPD
• Mass General Brigham Community Physicians Inc.

  • Family Medicine Physician
  • Boston, MA
  • NPI 1265094122
  NPD

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1104219583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6209 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042702",
            "telephone_number": "718-234-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6209 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042702",
            "telephone_number": "718-234-0073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Connecticut Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200361722",
            "country_code": "US",
            "telephone_number": "415-658-6791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "53 State St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021092820",
            "country_code": "US",
            "telephone_number": "617-903-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STATMAN",
        "first_name": "NINA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-10",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "125121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200001961",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "094010-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henrietta Statham, LCSW
• Konstantinos Stathopoulos, D.D.S
• Station Care PT PC
• Joshua Statman, D.P.T.
• Meyer Statman, D.O.
• Statmdny
• Frederick Staton, MD
• Jessica Staton, RN
• Mark Edward Staton
• Sabrina Staton

• Social Worker in Brooklyn, NY
• Providers in Brooklyn, 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 May 1, 2025; 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.