Individual provider Active NPI

Maryann Ciccarelli, MSW

  • Clinical Social Worker
  • Commack, NY
National Provider Identifier
1225168966
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
32831R Issued in NY
Practice address
145 Commack Rd
Suite 13
Commack, NY 11725-3438
Phone
(631) 368-0392
NPI assigned
Mar 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 32831R NY Primary

Addresses

Primary practice location

145 Commack Rd
Suite 13
Commack, NY 11725-3438

Mailing address

145 Commack Rd
Suite 13
Commack, NY 11725-3438
Phone (631) 368-0392

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
I20050126000711 NY Practitioner - Clinical Social Worker 2567412638 Practice locations: Commack, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

145 Commack Rd
Suite 13
Commack, NY 11725-3438
Phone (631) 368-0392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32831RNYMDClinical Social Worker
032831NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225168966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 COMMACK RD",
            "address_2": "SUITE 13",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253438",
            "telephone_number": "631-368-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 COMMACK RD",
            "address_2": "SUITE 13",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253438",
            "telephone_number": "631-368-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCARELLI",
        "first_name": "MARYANN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "32831R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.