Individual provider Active NPI

Sandra Albukrek, LCSW

  • Clinical Social Worker
  • East Hampton, NY
National Provider Identifier
1114137239
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
074651-1 Issued in NY
Practice address
34 Pantigo Rd
East Hampton, NY 11937-2607
Phone
(917) 750-1252
NPI assigned
May 24, 2007
Last updated
Dec 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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 074651-1 NY Primary

Addresses

Primary practice location

34 Pantigo Rd
East Hampton, NY 11937-2607

Mailing address

10 Talkhouse Walk
East Hampton, NY 11937-1894

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
I20140515000051 NY Practitioner - Clinical Social Worker 6507089786 Practice locations: Amagansett, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 Talkhouse Walk
East Hampton, NY 11937-1894

518 Montauk Hwy
Amagansett, NY 11930-2110
Phone (917) 750-1252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
074651-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1114137239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TALKHOUSE WALK",
            "city": "EAST HAMPTON",
            "state": "NY",
            "postal_code": "119371894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PANTIGO RD",
            "city": "EAST HAMPTON",
            "state": "NY",
            "postal_code": "119372607",
            "telephone_number": "917-750-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBUKREK",
        "first_name": "SANDRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074651-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hampton, NY

Sources for this page

Verify at the official NPI Registry.