Individual provider Active NPI

Paul W. Zampieron, LCSW-R

  • Clinical Social Worker
  • Port Jefferson Station, NY
National Provider Identifier
1134343973
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071065-R Issued in NY
Practice address
1050 Hallock Ave
Port Jefferson Station, NY 11776-1214
Phone
(631) 680-0304
Fax
(631) 473-3091
NPI assigned
Apr 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 071065-R NY Primary

Addresses

Primary practice location

1050 Hallock Ave
Port Jefferson Station, NY 11776-1214

Mailing address

1050 Hallock Ave
Port Jefferson Station, NY 11776-1214
Phone (631) 680-0304

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
I20160615000347 NY Practitioner - Clinical Social Worker 1355632753 Reassigns benefits to 2 organizations
Practice locations: Port Jefferson Station, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1050 Hallock Ave
Suite 4
Port Jefferson Station, NY 11776-1214
Phone (631) 680-0304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071065-RNYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Living Behavioral Health LCSW PLLC Clinical CurrentSince Mar 9, 2019 Accepting new patients
Long Island Elder Care LCSW PLLC CurrentSince Jul 13, 2018 Accepting new patients

Locations

1065 Smithtown Ave
Bohemia, NY 11716
Phone (631) 388-7616

Networks

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

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134343973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 HALLOCK AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761214",
            "telephone_number": "631-680-0304",
            "fax_number": "631-473-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 HALLOCK AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761214",
            "telephone_number": "631-680-0304",
            "fax_number": "631-473-3091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMPIERON",
        "first_name": "PAUL",
        "middle_name": "W.",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071065-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

Verify at the official NPI Registry.