Individual provider Active NPI

Patricia Susan Lane-Pennimpede, L-CSW-R

  • Clinical Social Worker
  • New Windsor, NY
National Provider Identifier
1184770935
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L-026551-R Issued in NY
Practice address
340 Oak Dr
New Windsor, NY 12553-5829
Phone
(845) 496-0617
Fax
(845) 496-0617
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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 L-026551-R NY Primary

Addresses

Primary practice location

340 Oak Dr
New Windsor, NY 12553-5829

Mailing address

340 Oak Dr
New Windsor, NY 12553-5829
Phone (845) 496-0617

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
I20121018000295 NY Practitioner - Clinical Social Worker 4284714528 Practice locations: New Windsor, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

340 Oak Dr
New Windsor, NY 12553-5829
Phone (845) 496-0617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L-026551-RNYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1184770935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 OAK DR",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535829",
            "telephone_number": "845-496-0617",
            "fax_number": "845-496-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 OAK DR",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535829",
            "telephone_number": "845-496-0617",
            "fax_number": "845-496-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE-PENNIMPEDE",
        "first_name": "PATRICIA",
        "middle_name": "SUSAN",
        "credential": "L-CSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "L-026551-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Windsor, NY

Sources for this page

Verify at the official NPI Registry.