Jack De Santis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

PR0047581 Issued in NY

Practice address

368 Veterans Memorial Highway
Suite #1
Commack, NY 11725-4315

Phone

(631) 543-8779

Fax

(631) 361-8865

NPI assigned

Dec 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 1967

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245398197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 RIDGEFIELD ROAD",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882312",
            "telephone_number": "631-361-8865",
            "fax_number": "631-361-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 VETERANS MEMORIAL HIGHWAY",
            "address_2": "SUITE #1",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254315",
            "telephone_number": "631-543-8779",
            "fax_number": "631-361-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE SANTIS",
        "first_name": "JACK",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR0047581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Davidson, LMHC
• Stuart Lyle Dawson, M.D.
• Rayhanna Jonaif De Jesus Alvarez
• Mary Nancy De la Cruz
• De Medical Ny PC
• Makeda Emelie De Souza, LMHC
• Lisa Jill Deblasi, R.N
• Karen L Defalco, PSY.D.
• Christine Deguardia
• Elizabeth Linda Del Giudice, LMSW

• Clinical Social Worker in Commack, NY
• Providers in Commack, 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 Jul 8, 2007; 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.