Individual provider Active NPI

Jennifer Ann Ufko, LCSW-R, ACSW

  • Clinical Social Worker
  • Smithtown, NY
National Provider Identifier
1215928395
Registry record updated May 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R070197-1 Issued in NY
Practice address
18 Princeton Avenue
Smithtown, NY 11787
Phone
(631) 366-0376
NPI assigned
Oct 28, 2005
Last updated
May 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 070197-1 NY
Clinical Social Worker 1041C0700X R070197-1 NY Primary

Addresses

Primary practice location

18 Princeton Avenue
Smithtown, NY 11787

Mailing address

18 Princeton Avenue
Smithtown, NY 11787
Phone (631) 366-0376

Other names 1

  • Jennifer Ann Freese Former name

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
I20050929000848 NY Practitioner - Clinical Social Worker 9436184298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jennifer Ufko LCSW PLLCGroup PAC ID 9234454315, 2 clinicians

Practice addresses (Care Compare)

111 Smithtown Byp
Suite 207
Hauppauge, NY 11788-2512
Phone (631) 374-5815

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070197-1NYMDSocial Worker
R070197-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Ufko, LCSW, PLLC Clinical CurrentSince Nov 17, 2014 Accepting new patients
Laura E Asner CSW PC Clinical PastSince May 1, 1995 Accepting new patients
Senior Options Systems LLP Clinical Past Accepting new patients

Locations

111 Smithtown Byp
Ste 207
Hauppauge, NY 11788
Phone (631) 374-5815

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, 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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1215928395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 PRINCETON AVENUE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-366-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 PRINCETON AVENUE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-366-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UFKO",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "070197-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R070197-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "FREESE",
            "middle_name": "ANN",
            "credential": "LCSW-R, ACSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.