Individual provider Active NPI

Donald T Gardiner, L.C.S.W.R.

  • Clinical Social Worker
  • East Syracuse, NY
National Provider Identifier
1164520185
Registry record updated Mar 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34577R Issued in NY
Practice address
5800 Heritage Landing Dr
Suite E
East Syracuse, NY 13057-9378
Phone
(315) 472-7885
Fax
(315) 472-2513
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2009

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 34577R NY Primary

Addresses

Primary practice location

5800 Heritage Landing Dr
Suite E
East Syracuse, NY 13057-9378

Mailing address

5800 Heritage Landing Dr
Suite E
East Syracuse, NY 13057-9378
Phone (315) 472-7885

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
I20070721000029 NY Practitioner - Clinical Social Worker 6608979000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Nova Southeastern College of Osteo Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dewitt Counseling Associates LCSW PCGroup PAC ID 3870765597, 2 clinicians

Practice addresses (Care Compare)

892 E Brighton Ave
Suite 2
Syracuse, NY 13205-2542
Phone (315) 472-7885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34577RNYMDClinical Social Worker
034577NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dewitt Counseling Associates, LCSW, PC Clinical CurrentSince Sep 1, 2011 Accepting new patients
Janis L. Scaturo LCSW, P.C. Past Accepting new patients
MH-Cny-FL Medical PC PastSince Jun 12, 2009 Accepting new patients
Barbara J. Miller, M.D., P.C. Past Accepting new patients
Onondaga Pastoral Counseling Center Inc Past Accepting new patients

Locations

892 E Brighton Ave
Ste 2
Syracuse, NY 13205
Phone (315) 472-7885

890 E Brighton Ave
Syracuse, NY 13205
Phone (315) 471-5677

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237334400000",
    "number": "1164520185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 HERITAGE LANDING DR",
            "address_2": "SUITE E",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579378",
            "telephone_number": "315-472-7885",
            "fax_number": "315-472-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 HERITAGE LANDING DR",
            "address_2": "SUITE E",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579378",
            "telephone_number": "315-472-7885",
            "fax_number": "315-472-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDINER",
        "first_name": "DONALD",
        "middle_name": "T",
        "credential": "L.C.S.W.R.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2009-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "34577R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.