Individual provider Active NPI

Lynn E Miles Timineri, LCSW-R

  • Clinical Social Worker
  • Rochester, NY
National Provider Identifier
1184714800
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R028655 Issued in NY
Practice address
3300 Monroe Ave
Suite 309
Rochester, NY 14618-4624
Phone
(585) 383-8710
Fax
(585) 383-8609
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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 R028655 NY Primary

Addresses

Primary practice location

3300 Monroe Ave
Suite 309
Rochester, NY 14618-4624

Mailing address

3300 Monroe Ave
Suite 309
Rochester, NY 14618-4624
Phone (585) 383-8710

Other identifiers 2

IdentifierTypeStateIssuer
7300546OtherNYAETHNA HEALTH INS
P010028655OtherNYBLUE PRODUCTS

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
I20181129002330 NY Practitioner - Clinical Social Worker 4981948056 Practice locations: Pittsford, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R028655NYMDClinical Social Worker
028655NYMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1184714800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 MONROE AVE",
            "address_2": "SUITE 309",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146184624",
            "telephone_number": "585-383-8710",
            "fax_number": "585-383-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MONROE AVE",
            "address_2": "SUITE 309",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146184624",
            "telephone_number": "585-383-8710",
            "fax_number": "585-383-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES TIMINERI",
        "first_name": "LYNN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R028655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETHNA HEALTH INS",
            "identifier": "7300546",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE PRODUCTS",
            "identifier": "P010028655",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.