Individual provider Active NPI

Brent P Baynon Jr., LCSW

  • Clinical Social Worker
  • East Meadow, NY
National Provider Identifier
1104588615
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
100287 Issued in NY
Practice address
1500 Hempstead Tpke
East Meadow, NY 11554-1551
Phone
(516) 739-7733
NPI assigned
Oct 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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 100287 NY Primary

Addresses

Primary practice location

1500 Hempstead Tpke
East Meadow, NY 11554-1551

Mailing address

41 Doncaster Ave
West Islip, NY 11795-1220
Phone (631) 492-0034

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
I20250801003703 NY Practitioner - Clinical Social Worker 3678081502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Epic Long IslandGroup PAC ID 7315835907, 43 clinicians

Practice addresses (Care Compare)

1500 Hempstead Tpke
East Meadow, NY 11554-1551
Phone 5167397733420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100287NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Long Island CurrentSince Jun 1, 2025 Accepting new patients
Epilepsy Foundation of L.I. CurrentSince Jun 1, 2025 Accepting new patients

Locations

1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420

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": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1104588615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 DONCASTER AVE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117951220",
            "telephone_number": "631-492-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541551",
            "telephone_number": "516-739-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYNON",
        "first_name": "BRENT",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-12",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "100287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.