Individual provider Active NPI

Maryann Elizabeth Gensler

  • Social Worker
  • Southold, NY
National Provider Identifier
1134617673
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
096781 Issued in NY
Practice address
11900 Soundview Ave
Southold, NY 11971-2721
Phone
(631) 276-2499
NPI assigned
Apr 30, 2018
Last updated
Apr 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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 096781 NY Primary

Addresses

Primary practice location

11900 Soundview Ave
Southold, NY 11971-2721

Mailing address

PO Box 193
Southold, NY 11971-0193
Phone (631) 407-3505

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
I20250124001914 NY Practitioner - Clinical Social Worker 0749719433 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
096781NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA CurrentSince Dec 24, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

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, 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": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1134617673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 193",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "119710193",
            "telephone_number": "631-407-3505",
            "fax_number": "631-407-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 SOUNDVIEW AVE",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "119712721",
            "telephone_number": "631-276-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENSLER",
        "first_name": "MARYANN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "096781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southold, NY

Sources for this page

Verify at the official NPI Registry.