Individual provider Active NPI

Julie Costantino Wiley, LCSW-R

  • Clinical Social Worker
  • Getzville, NY
National Provider Identifier
1174237085
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
063165 Issued in NY
Practice address
55 Dodge Rd
Getzville, NY 14068-1205
Phone
(716) 650-5100
NPI assigned
Jan 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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 063165 NY Primary

Addresses

Primary practice location

55 Dodge Rd
Getzville, NY 14068-1205

Mailing address

55 Dodge Rd
Getzville, NY 14068-1205
Phone (716) 831-2700

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
I20230126002243 NY Practitioner - Clinical Social Worker 3274904487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Horizon Health Services IncGroup PAC ID 5698689925, 144 clinicians

Practice addresses (Care Compare)

55 Dodge Rd
Getzville, NY 14068-1205
Phone (716) 650-5100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
063165NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Health Services Inc CurrentSince Jan 3, 2023 Accepting new patients

Locations

3020 Bailey Ave
Cheektowaga, NY 14215
Phone (716) 831-0200

55 Dodge Rd
Getzville, NY 14068
Phone (716) 650-5100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEGDAA

Organizations & group practices 1

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": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1174237085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DODGE RD",
            "city": "GETZVILLE",
            "state": "NY",
            "postal_code": "140681205",
            "telephone_number": "716-831-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 DODGE RD",
            "city": "GETZVILLE",
            "state": "NY",
            "postal_code": "140681205",
            "telephone_number": "716-650-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "JULIE",
        "middle_name": "COSTANTINO",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "063165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Getzville, NY

Sources for this page

Verify at the official NPI Registry.