Individual provider Active NPI

Anna Halberstadt-Komar, MA LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1174634257
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PRO 34753-1 Issued in NY
Practice address
920 Broadway
8 Floor, St. 12
New York, NY 10010
Phone
(646) 248-0788
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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 PRO 34753-1 NY Primary

Addresses

Primary practice location

920 Broadway
8 Floor, St. 12
New York, NY 10010

Mailing address

718 Broadway
#5D
New York, NY 10003
Phone (212) 777-6653

Other identifiers 1

IdentifierTypeStateIssuer
NS4095OtherNYOXFORD

Other names 1

  • Anna Cherupistaya Former name

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
I20040525000779 NY Practitioner - Clinical Social Worker 7416938618 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

718 Broadway
Apt 5D
New York, NY 10003-9523
Phone (646) 248-0788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
PRO 34753-1NYMDClinical Social Worker
034753NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1174634257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 BROADWAY",
            "address_2": "#5D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-777-6653",
            "fax_number": "212-777-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 BROADWAY",
            "address_2": "8 FLOOR, ST. 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10010",
            "telephone_number": "646-248-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALBERSTADT-KOMAR",
        "first_name": "ANNA",
        "credential": "MA LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PRO 34753-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "NS4095",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "CHERUPISTAYA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.