Individual provider Active NPI

Sandra Ruggiero, LCSW

  • Clinical Social Worker
  • Kings Park, NY
National Provider Identifier
1205079944
Registry record updated Jan 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R048870-1 Issued in NY
Practice address
47 Winnecomac Cir
Kings Park, NY 11754-4608
Phone
(516) 647-8708
Fax
(631) 385-5956
NPI assigned
Apr 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 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 R048870-1 NY Primary

Addresses

Primary practice location

47 Winnecomac Cir
Kings Park, NY 11754-4608

Mailing address

47 Winnecomac Cir
Kings Park, NY 11754-4608
Phone (516) 647-8708

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
I20100723000241 NY Practitioner - Clinical Social Worker 3476685637 Reassigns benefits to 1 organization
Practice locations: Huntington, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

775 Park Ave
Huntington, NY 11743-3976
Phone (516) 647-8708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R048870-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care at Home PC CurrentSince Aug 1, 2024 Accepting new patients

Locations

220 E 42nd St
Fl 6
New York, NY 10017
Phone (212) 609-9640

5065 Wooster Rd
Cincinnati, OH 45226

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": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674950400000",
    "number": "1205079944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 WINNECOMAC CIR",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117544608",
            "telephone_number": "516-647-8708",
            "fax_number": "631-385-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 WINNECOMAC CIR",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117544608",
            "telephone_number": "516-647-8708",
            "fax_number": "631-385-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGIERO",
        "first_name": "SANDRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-10",
        "last_updated": "2023-01-29",
        "certification_date": "2023-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R048870-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

Verify at the official NPI Registry.