Individual provider Active NPI

Angelo L D'Esposito, LCSW, SAP, CAMS-II

  • Clinical Social Worker
  • Medford, NY
National Provider Identifier
1134527054
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
088952 Issued in NY
Practice address
77 Robinson Ave
Medford, NY 11763
Phone
(917) 921-4877
NPI assigned
Dec 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 093855-1 NY
Clinical Social Worker 1041C0700X 088952 NY Primary

Addresses

Primary practice location

77 Robinson Ave
Medford, NY 11763

Mailing address

77 Robinson Ave
Medford, NY 11763
Phone (917) 921-4877

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
I20210109000026 NY Practitioner - Clinical Social Worker 4385057462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Stony Brook, School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sunrise Counseling Center,LTDGroup PAC ID 8224210232, 20 clinicians

Practice addresses (Care Compare)

107 W Main St
East Islip, NY 11730-2337
Phone (631) 666-1615

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
093855-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Counseling Center,LTD Clinical CurrentSince Nov 1, 2020 Accepting new patients

Locations

107 W Main St
East Islip, NY 11730
Phone (631) 666-1615

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": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1134527054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 ROBINSON AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "11763",
            "telephone_number": "917-921-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 ROBINSON AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "11763",
            "telephone_number": "917-921-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ESPOSITO",
        "first_name": "ANGELO",
        "middle_name": "L",
        "credential": "LCSW, SAP, CAMS-II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-09",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093855-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

Verify at the official NPI Registry.