Individual provider Active NPI

Lois Mergentime, LCSW

  • Clinical Social Worker
  • Nyack, NY
National Provider Identifier
1124035852
Registry record updated Apr 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR024991-1 Issued in NY
Practice address
271 S Broadway
Nyack, NY 10960-4636
Phone
(845) 641-9595
Fax
(845) 267-2173
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2017

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 PR024991-1 NY Primary

Addresses

Primary practice location

271 S Broadway
Nyack, NY 10960-4636

Mailing address

272 Piermont Ave
Nyack, NY 10960-4663
Phone (845) 353-0890

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
I20060901000172 NY Practitioner - Clinical Social Worker 2062416159 Practice locations: Nyack, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

271 S Broadway
Nyack, NY 10960-4636
Phone (845) 641-9595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR024991-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Beldini Physical Therapy PC PastSince Oct 1, 2020 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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492905600000",
    "number": "1124035852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 PIERMONT AVE",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109604663",
            "telephone_number": "845-353-0890",
            "fax_number": "845-267-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 S BROADWAY",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109604636",
            "telephone_number": "845-641-9595",
            "fax_number": "845-267-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERGENTIME",
        "first_name": "LOIS",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2017-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR024991-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nyack, NY

Sources for this page

Verify at the official NPI Registry.