Individual provider Active NPI

Susan Weil

  • Social Worker
  • White Plains, NY
National Provider Identifier
1265766851
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
083016 Issued in NY
Practice address
19 Greenridge Ave
C/O Andrus Children'S Center
White Plains, NY 10605-1201
Phone
(914) 949-7680
Fax
(914) 949-3224
NPI assigned
Sep 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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
Social Worker 104100000X 083016 NY Primary

Addresses

Primary practice location

19 Greenridge Ave
C/O Andrus Children'S Center
White Plains, NY 10605-1201

Mailing address

49 Ridgefield Avenue
South Salem, NY 10590
Phone (914) 949-7699

Other identifiers 3

IdentifierTypeStateIssuer
WVE061OtherNYMEDICARE #
00355940MedicaidNY
1285628552OtherNYANDRUS AGENCY

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
I20161007000424 NY Practitioner - Clinical Social Worker 8325336373 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
083016NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Feb 13, 2017 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Feb 13, 2017 Accepting new patients
Julia Dyckman Andrus Memorial, Inc. CurrentSince Jul 9, 2016 Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

19 Greenridge Ave
White Plains, NY 10605
Phone (914) 949-7680

1156 N Broadway
Yonkers, NY 10701
Phone (914) 965-3700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1265766851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 RIDGEFIELD AVENUE",
            "city": "SOUTH SALEM",
            "state": "NY",
            "postal_code": "10590",
            "telephone_number": "914-949-7699",
            "fax_number": "914-949-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 GREENRIDGE AVE",
            "address_2": "C/O ANDRUS CHILDREN'S CENTER",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051201",
            "telephone_number": "914-949-7680",
            "fax_number": "914-949-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIL",
        "first_name": "SUSAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "083016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE #",
            "identifier": "WVE061",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00355940",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANDRUS AGENCY",
            "identifier": "1285628552",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.