Active NPI
Martin Wakesberg, MSW
- Clinical Social Worker
- Glenville, NY
National Provider Identifier
1144281833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R017417-1
- Practice address
- 113 Saratoga Rd
Glenville, NY 12302-7100 - Phone
- (518) 399-0637
- Fax
- (518) 399-7195
- NPI assigned
- Mar 31, 2006
- Last updated
- Jan 3, 2020
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R017417-1 | NY | Primary |
Addresses
Primary practice location
113 Saratoga Rd
Glenville, NY 12302-7100
Mailing address
1 Brierwood CT
Burnt Hills, NY 12027-9451
Phone (518) 399-6741
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040816000038 | NY | Practitioner - Clinical Social Worker | 6709859143 | Practice locations: Glenville, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
113 Saratoga Rd
Glenville, NY 12302-7144
Phone (518) 399-0637
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R017417-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578009600000",
"number": "1144281833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BRIERWOOD CT",
"city": "BURNT HILLS",
"state": "NY",
"postal_code": "120279451",
"telephone_number": "518-399-6741",
"fax_number": "518-399-7195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 SARATOGA RD",
"city": "GLENVILLE",
"state": "NY",
"postal_code": "123027100",
"telephone_number": "518-399-0637",
"fax_number": "518-399-7195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAKESBERG",
"first_name": "MARTIN",
"name_prefix": "Mr.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2020-01-03",
"certification_date": "2020-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R017417-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenville, NY
- Thrive Chiropractic, PC
- Kelly Ann Torres, MS TSHH
- Cherie Mai Turner, C.O.T.A.
- Kevin Daniel Valade, RPH
- Teri Lynn Vanepps, OTR/L
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2874)
- Wal-Mart Stores East, LP (Vision Center 30-2874)
- Maria Westbrook, LCSW
- Alicia Lynne Westfall, B.S
- Lyndsay Wilson, CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.