Individual provider Active NPI

Michael Stuart Burns, LCSW

  • Clinical Social Worker
  • Commack, NY
National Provider Identifier
1114934478
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR054203 Issued in NY
Practice address
145 Commack Rd
Suite 1
Commack, NY 11725-3438
Phone
(631) 543-4673
Fax
(631) 325-2839
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

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 PR054203 NY Primary

Addresses

Primary practice location

145 Commack Rd
Suite 1
Commack, NY 11725-3438

Mailing address

145 Commack Rd
Suite 1
Commack, NY 11725-3438
Phone (631) 543-4673

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
I20160909000793 NY Practitioner - Clinical Social Worker 9931495439 Practice locations: Commack, 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
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

145 Commack Rd
Suite 1
Commack, NY 11725-3438
Phone (631) 543-4673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR054203NYMDClinical Social Worker

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114934478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 COMMACK RD",
            "address_2": "SUITE 1",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253438",
            "telephone_number": "631-543-4673",
            "fax_number": "631-325-2839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 COMMACK RD",
            "address_2": "SUITE 1",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253438",
            "telephone_number": "631-543-4673",
            "fax_number": "631-325-2839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "MICHAEL",
        "middle_name": "STUART",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR054203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.