Jason Michael Kreisberg

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

091105 Issued in NY

Practice address

16 Main St
Hempstead, NY 11550-4020

Phone

(516) 489-2322

NPI assigned

Jun 19, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Long Island Counseling LCSW PCGroup PAC ID 7113266131, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Long Island Counseling LCSW PC

  • Clinical Social Worker
  • East Meadow, NY
  • NPI 1366894750
  Medicare reassignment Care Compare group NPD
• Douglas a. Byrnes, MD, PC

  • Cardiovascular Disease Physician
  • Huntington, NY
  • NPI 1619156825
  NPD (past)

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1184284333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MAIN ST",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115504020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MAIN ST",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115504020",
            "telephone_number": "516-489-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREISBERG",
        "first_name": "JASON",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-19",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091105",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "094785",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kadiatu Koroma
• Saby Koshy
• Roshan Kothandaram, M.D
• Ulka Tarush Kothari, MBBS
• Kparikhdentalp.C
• KS Family Health Nurse Practitioner PLLC
• Satish Kumar, PHYSICAL THERAPIST
• Renee Gene Lacouette, PA-C
• Maryanne Laffin, CNM
• Isabelle Anne Lagasse

• Clinical Social Worker in Hempstead, NY
• Providers in Hempstead, 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 Mar 17, 2021; 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.