Individual provider Active NPI

Virginia Lois Medina-Lomas, LCSW-R

  • Clinical Social Worker
  • Selden, NY
National Provider Identifier
1114960366
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R072198-1 Issued in NY
Practice address
1305 Middle Country Rd Ste 14D
Selden, NY 11784-2554
Phone
(631) 833-8266
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 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 R072198-1 NY Primary

Addresses

Primary practice location

1305 Middle Country Rd Ste 14D
Selden, NY 11784-2554

Mailing address

77 Gauguin Court
Middle Island
New York, NY 11953-2003
Phone (631) 833-8266

Other practice location 1

77 Gauguin Ct
Middle Island, NY 11953-2003
Phone (631) 345-3016

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
I20190103002966 NY Order and Referring Only - Clinical Social Worker 7618988676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R072198-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia L Medina-Lomas, LCSW-R Clinical PastSince Jan 12, 2025 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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1114960366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 GAUGUIN COURT",
            "address_2": "MIDDLE ISLAND",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "119532003",
            "telephone_number": "631-833-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 MIDDLE COUNTRY RD STE 14D",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117842554",
            "telephone_number": "631-833-8266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Gauguin Ct",
            "address_purpose": "LOCATION",
            "city": "Middle Island",
            "state": "NY",
            "postal_code": "119532003",
            "country_code": "US",
            "telephone_number": "631-345-3016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA-LOMAS",
        "first_name": "VIRGINIA",
        "middle_name": "LOIS",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R072198-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selden, NY

Sources for this page

Verify at the official NPI Registry.