Richard Wallace Koffler, CASAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R069801 Issued in NY

Practice address

1666 Bell Blvd Apt 724
Bayside, NY 11360-1656

Phone

(917) 597-5592

Fax

(718) 428-2705

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1154494102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 BELL BLVD APT 724",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601656",
            "telephone_number": "917-597-5592",
            "fax_number": "718-428-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 BELL BLVD APT 724",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601656",
            "telephone_number": "917-597-5592",
            "fax_number": "718-428-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFFLER",
        "first_name": "RICHARD",
        "middle_name": "WALLACE",
        "credential": "CASAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R069801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Faith Ko
• Esther Ko
• Injung Ko, NP
• Jesse Ko, M.D.
• Stanley G Ko
• Omid Kohani, MD
• Michael Kokolis, DDS
• Adam J Kolesar, MSP.,CCC-SLP, BRS-S
• Panayota Penny Kollias-Stroumbakis, D.D.S.
• Faye Jennifer Cabrera Konecky

• Clinical Social Worker in Bayside, NY
• Providers in Bayside, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.

Verify at the official NPI Registry.