Individual provider Active NPI

Debra Jane Pitman, DSW, LCSW

  • Clinical Social Worker
  • Wantagh, NY
National Provider Identifier
1144314253
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR023304-1 Issued in NY
Practice address
12 Red Maple Dr N
Wantagh, NY 11793-1528
Phone
(516) 799-2408
Fax
(516) 765-3676
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X PR023304-1 NY Primary

Addresses

Primary practice location

12 Red Maple Dr N
Wantagh, NY 11793-1528

Mailing address

208 Whitewood Drive
Massapequa Park, NY 11762-4050
Phone (516) 799-2408

Other identifiers 5

IdentifierTypeStateIssuer
199321OtherNYMHN
7401525OtherNYGHI
P492112OtherNYOXFORD
147582OtherNYVALUE OPTIONS
1049706OtherNYCIGNA

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
I20101119000698 NY Practitioner - Clinical Social Worker 3072709757 Practice locations: Wantagh, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12 Red Maple Dr N
Wantagh, NY 11793-1528
Phone (516) 799-2408

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1144314253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 WHITEWOOD DRIVE",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117624050",
            "telephone_number": "516-799-2408",
            "fax_number": "516-799-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 RED MAPLE DR N",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117931528",
            "telephone_number": "516-799-2408",
            "fax_number": "516-765-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITMAN",
        "first_name": "DEBRA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "DSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR023304-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "199321",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7401525",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P492112",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "147582",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1049706",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

Verify at the official NPI Registry.