Individual provider Active NPI

Mary Anne Giampetruzzi, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1164589503
Registry record updated Apr 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
NYSR047541-1 Issued in NY
Practice address
80 E 11TH St
201
New York, NY 10003-6811
Phone
(917) 716-6578
Fax
(718) 459-3059
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2013

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 NYSR047541-1 NY Primary

Addresses

Primary practice location

80 E 11TH St
201
New York, NY 10003-6811

Mailing address

10011 67TH Rd
226
Forest Hills, NY 11375-2754
Phone (917) 716-6578

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
I20040219000885 NY Practitioner - Clinical Social Worker 5597650390 Practice locations: Forest Hills, NY; New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

80 E 11TH St
Suite 201
New York, NY 10003-6823
Phone (917) 716-6578

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NYSR047541-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366502400000",
    "number": "1164589503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10011 67TH RD",
            "address_2": "226",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752754",
            "telephone_number": "917-716-6578",
            "fax_number": "718-459-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 E 11TH ST",
            "address_2": "201",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100036811",
            "telephone_number": "917-716-6578",
            "fax_number": "718-459-3059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIAMPETRUZZI",
        "first_name": "MARY ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2013-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "NYSR047541-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.