Individual provider Active NPI

Lucy Pecorella, LMSW

  • Social Worker
  • Ridgewood, NY
National Provider Identifier
1134492366
Registry record updated Feb 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
083612 Issued in NY
Practice address
360 Onderdonk Ave
Ridgewood, NY 11385-1321
Phone
(718) 536-4555
NPI assigned
Feb 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 083612 NY Primary

Addresses

Primary practice location

360 Onderdonk Ave
Ridgewood, NY 11385-1321

Mailing address

360 Onderdonk Ave
Ridgewood, NY 11385-1321
Phone (718) 536-4555

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
I20211008002565 NY Practitioner - Clinical Social Worker 2860890605 Practice locations: Ridgewood, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

360 Onderdonk Ave
Ridgewood, NY 11385-1321
Phone (718) 536-4555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
083612NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1329609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329609600000",
    "number": "1134492366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 ONDERDONK AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113851321",
            "telephone_number": "718-536-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 ONDERDONK AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113851321",
            "telephone_number": "718-536-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECORELLA",
        "first_name": "LUCY",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-19",
        "last_updated": "2012-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "083612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NY

Sources for this page

Verify at the official NPI Registry.