Active NPI
Wayne Marcus, LMSW
- Social Worker
- Lido Beach, NY
National Provider Identifier
1134586381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 050105-1
- Practice address
- 31 Regent Dr
Lido Beach, NY 11561-4922 - Phone
- (917) 674-0818
- NPI assigned
- Jan 19, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 050105-1 | NY | Primary |
Addresses
Primary practice location
31 Regent Dr
Lido Beach, NY 11561-4922
Mailing address
409 Smith St
#4
Peekskill, NY 10566-4541
Phone (917) 674-0818
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050105-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665964800000",
"number": "1134586381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 SMITH ST",
"address_2": "#4",
"city": "PEEKSKILL",
"state": "NY",
"postal_code": "105664541",
"telephone_number": "917-674-0818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 REGENT DR",
"city": "LIDO BEACH",
"state": "NY",
"postal_code": "115614922",
"telephone_number": "917-674-0818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCUS",
"first_name": "WAYNE",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-01-19",
"last_updated": "2022-10-17",
"certification_date": "2022-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "050105-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lido Beach, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.