Individual provider Active NPI

Chet Gates-Lupton, LCSW

  • Clinical Social Worker
  • Ithaca, NY
National Provider Identifier
1215196118
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
73-073515 Issued in NY
Practice address
127 W State St
Ithaca, NY 14850-5474
Phone
(607) 273-7494
NPI assigned
Jun 5, 2008
Last updated
Sep 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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 73-073515 NY Primary

Addresses

Primary practice location

127 W State St
Ithaca, NY 14850-5474

Mailing address

127 W. State St.
Ithaca, NY 14850-5474
Phone (607) 273-7494

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
I20060316000171 NY Practitioner - Clinical Social Worker 2961419965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family and Childrens Service of Ithaca IncGroup PAC ID 0446249957, 12 clinicians

Practice addresses (Care Compare)

127 W State/ MLK Jr St
Floor 1
Ithaca, NY 14850-5474
Phone (607) 273-7494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
73-073515NYMDClinical Social Worker
073515NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Children's Service of Ithaca Inc CurrentSince Feb 14, 2006 Accepting new patients
Family and Children Services of Ithaca Past Accepting new patients

Locations

127 W State St
Ithaca, NY 14850
Phone (607) 273-7494

127 W State St
Fl 1
Ithaca, NY 14850
Phone (607) 273-7494

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1215196118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W. STATE ST.",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505474",
            "telephone_number": "607-273-7494",
            "fax_number": "607-273-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505474",
            "telephone_number": "607-273-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES-LUPTON",
        "first_name": "CHET",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-05",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73-073515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.