Individual provider Active NPI

Patricia Bryan, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1295923621
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
078773 Issued in NY
Practice address
853 Broadway
Suite 2001
New York, NY 10003-4703
Phone
(212) 987-1910
NPI assigned
Oct 10, 2007
Last updated
Sep 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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 078773 NY Primary

Addresses

Primary practice location

853 Broadway
Suite 2001
New York, NY 10003-4703

Mailing address

210 E 88TH St
Apt 3C
New York, NY 10128-3321
Phone (212) 987-1910

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
I20111220000561 NY Practitioner - Clinical Social Worker 5092981126 Practice locations: Glen Wild, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

754 Marsh Rd
Glen Wild, NY 12738-7722
Phone (917) 208-9317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078773NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia Hunter Psy D PLLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1295923621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E 88TH ST",
            "address_2": "APT 3C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101283321",
            "telephone_number": "212-987-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 BROADWAY",
            "address_2": "SUITE 2001",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034703",
            "telephone_number": "212-987-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "PATRICIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-10",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.