Individual provider Active NPI

Arkady Utkin

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1205873015
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R057074-1 Issued in NY
Practice address
10 Flagship Cir
Staten Island, NY 10309-3979
Phone
(718) 227-7481
Fax
(718) 732-4558
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 R057074-1 NY Primary

Addresses

Primary practice location

10 Flagship Cir
Staten Island, NY 10309-3979

Mailing address

10 Flagship Cir
Staten Island, NY 10309-3979
Phone (718) 227-7481

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
I20040625000702 NY Practitioner - Clinical Social Worker 3779569298 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R057074-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
LCSW Evaluations and Clinical Social Work, P.C. Clinical CurrentSince May 26, 2011 Accepting new patients
Familyh Health Net PastSince May 30, 2011 Accepting new patients
Brooklyn Care Medical PC PastSince Oct 1, 2002 Accepting new patients
Ohel Children's Home and Family Services, Inc. Past Accepting new patients

Organizations & group practices 4

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205873015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FLAGSHIP CIR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093979",
            "telephone_number": "718-227-7481",
            "fax_number": "718-732-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 FLAGSHIP CIR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093979",
            "telephone_number": "718-227-7481",
            "fax_number": "718-732-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTKIN",
        "first_name": "ARKADY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R057074-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.