Active NPI
Antonio Ruberto Jr., LMSW
- Social Worker
- Freeport, NY
National Provider Identifier
1295052231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 075888-1
- Practice address
- 333 N Main St
Freeport, NY 11520-1231 - Phone
- (516) 623-3322
- NPI assigned
- Apr 30, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 075888-1 | NY | Primary |
Addresses
Primary practice location
333 N Main St
Freeport, NY 11520-1231
Mailing address
380 Bauer PL
Mineola, NY 11501-1340
Phone (516) 623-3322
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 075888-1 | Other | NY | LICENSE |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110322000536 | NY | Practitioner - Clinical Social Worker | 1557544012 | Practice locations: New York, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2007
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
16 Madison SQ W
Suite 1213
New York, NY 10010-1629
Phone (917) 484-2150
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 075888-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272585600000",
"number": "1295052231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "380 BAUER PL",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115011340",
"telephone_number": "516-623-3322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 N MAIN ST",
"city": "FREEPORT",
"state": "NY",
"postal_code": "115201231",
"telephone_number": "516-623-3322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBERTO",
"first_name": "ANTONIO",
"name_suffix": "Jr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-30",
"last_updated": "2010-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "075888-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "075888-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Freeport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2010; 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.