Individual provider Active NPI

Sara L Bernstein, MSW LCSW ACSW

  • Social Worker
  • Stony Brook, NY
National Provider Identifier
1295877850
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
036252 Issued in NY
Practice address
207 Hallock Rd
Suite 204
Stony Brook, NY 11790-3033
Phone
(631) 689-0418
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 036252 NY Primary

Addresses

Primary practice location

207 Hallock Rd
Suite 204
Stony Brook, NY 11790-3033

Mailing address

207 Hallock Rd
Suite 204
Stony Brook, NY 11790-3033
Phone (631) 689-0418

Other identifiers 1

IdentifierTypeStateIssuer
800009180OtherNYRRMC

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
I20120209000006 NY Practitioner - Clinical Social Worker 9032376678 Practice locations: Stony Brook, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

207 Hallock Rd
Suite 209
Stony Brook, NY 11790-3082
Phone (631) 689-0418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036252NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1295877850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 HALLOCK RD",
            "address_2": "SUITE 204",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903033",
            "telephone_number": "631-689-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 HALLOCK RD",
            "address_2": "SUITE 204",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903033",
            "telephone_number": "631-689-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "SARA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MSW LCSW ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "036252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "800009180",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.