Individual provider Active NPI

Jeffrey Francis Creed, LCSW

  • Clinical Social Worker
  • Manorville, NY
National Provider Identifier
1255989042
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
093213 Issued in NY
Practice address
3 Moran CT
Manorville, NY 11949-2554
Phone
(631) 566-8176
NPI assigned
Aug 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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 093213 NY Primary

Addresses

Primary practice location

3 Moran CT
Manorville, NY 11949-2554

Mailing address

3 Moran CT
Manorville, NY 11949-2554
Phone (631) 566-8176

Other practice location 1

7555 Main Rd
Mattituck, NY 11952-1516
Phone (631) 298-8642

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
I20220725001340 NY Practitioner - Clinical Social Worker 9638550536 Practice locations: Riverhead, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21 W 2ND St
Suite 14
Riverhead, NY 11901-2752
Phone (631) 566-8176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

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

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1255989042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MORAN CT",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492554",
            "telephone_number": "631-566-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MORAN CT",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492554",
            "telephone_number": "631-566-8176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7555 Main Rd",
            "address_purpose": "LOCATION",
            "city": "Mattituck",
            "state": "NY",
            "postal_code": "119521516",
            "country_code": "US",
            "telephone_number": "631-298-8642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CREED",
        "first_name": "JEFFREY",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manorville, NY

Sources for this page

Verify at the official NPI Registry.