Individual provider Active NPI

Connor McCann

  • Social Worker
  • New York, NY
National Provider Identifier
1215380340
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
097919 Issued in NY
Practice address
460 W 34TH St
New York, NY 10001-2320
Phone
(212) 273-6100
NPI assigned
Jul 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 097919 NY Primary

Addresses

Primary practice location

460 W 34TH St
New York, NY 10001-2320

Mailing address

160 Tanglewood Dr
Staten Island, NY 10308-1851
Phone (646) 241-8373

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
I20201120000983 NY Practitioner - Clinical Social Worker 4880005966 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Young Adult Institute IncGroup PAC ID 1153216353, 28 clinicians
Premier Healthcare IncGroup PAC ID 1254233158, 58 clinicians

Practice addresses (Care Compare)

227 E 41St St
FL 8
New York, NY 10017-6927
Phone (212) 273-6521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
089978NYMDSocial Worker
097919NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Healthcare, Inc. CurrentSince Aug 26, 2020 Accepting new patients
Young Adult Institute, Inc. CurrentSince Mar 9, 2025 Accepting new patients
Premier Healthcare, Inc. Current Accepting new patients

Locations

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

21111 Northern Blvd
#13292
Bayside, NY 11361
Phone (718) 705-1000

3060 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1790

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

227 E 41St St
New York, NY 10017

220 E 42nd St
Fl 8
New York, NY 10017
Phone (212) 273-2761

460 W 34th St
New York, NY 10001
Phone (212) 273-6515

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: connor.mccann.p1@direct.premierhealthcare.nextgenshare.com

Organizations & group practices 3

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": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1215380340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 TANGLEWOOD DR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103081851",
            "telephone_number": "646-241-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 W 34TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012320",
            "telephone_number": "212-273-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCANN",
        "first_name": "CONNOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-13",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "097919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.