Individual provider Active NPI

Kimberly Meere, LCSW

  • Clinical Social Worker
  • Jericho, NY
National Provider Identifier
1114372687
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
091058 Issued in NY
Practice address
400 Jericho Tpke
Ste 107
Jericho, NY 11753-1320
Phone
(516) 637-1525
NPI assigned
May 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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 091058 NY Primary

Addresses

Primary practice location

400 Jericho Tpke
Ste 107
Jericho, NY 11753-1320

Mailing address

10 Bensin Dr
Melville, NY 11747-2314
Phone (516) 637-1525

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
I20191022000696 NY Practitioner - Clinical Social Worker 1153653324 Practice locations: Melville, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

535 Broadhollow Rd
Suite B32
Melville, NY 11747-3714
Phone (516) 637-1525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
091058NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rachel Siegel-Joffe LCSW PLLC Clinical PastSince Oct 27, 2019 Accepting new patients

Organizations & group practices 1

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": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1114372687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BENSIN DR",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472314",
            "telephone_number": "516-637-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 JERICHO TPKE",
            "address_2": "STE 107",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531320",
            "telephone_number": "516-637-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEERE",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jericho, NY

Sources for this page

Verify at the official NPI Registry.