Mary Anderson, LCSWR

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R0505421 Issued in NU

Practice address

9 Baywood LN
Bayport, NY 11705-1727

Phone

(631) 941-9494

Fax

(631) 941-9494

NPI assigned

Oct 12, 2006

Last updated

Jun 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: maryanderson@tdh.allscriptsdirect.net

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.

• Mary Anderson LCSW PC

  • Clinical Social Worker
  • Bayport, NY
  • NPI 1508955022
  Medicare reassignment Authorized official
• Mary Anderson LCSW PC

  • Clinical Social Worker
  • Bayport, NY
  • NPI 1508505645
  NPD Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1245329796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BAYWOOD LN",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117051727",
            "telephone_number": "631-941-9494",
            "fax_number": "631-941-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 BAYWOOD LN",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117051727",
            "telephone_number": "631-941-9494",
            "fax_number": "631-941-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "LCSWR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": "R0505421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61020463081",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Alcindor
• Alexander Licensed Behavior Analyst PLLC
• Dawn Marie Alexander
• Ryan Alexandersen
• Lindsay Christine Alimena, D.M.D
• Nancy A Anderson, MACCSLP TSHH
• Kim M Andrunik, RN
• Tara Anglim, LCSW-R
• Shahla Arif
• Emily Arntsen

• Clinical Social Worker in Bayport, NY
• Providers in Bayport, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.