Samantha A Fantauzzi, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

098990 Issued in NY

Practice address

810 Southside Ave
West Islip, NY 11795-1420

Phone

(516) 592-1971

NPI assigned

Jan 12, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCJFAD

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.

• Long Island Select Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Central Islip, NY
  • NPI 1043663107
  Medicare reassignment NPD
• Long Island Select Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Riverhead, NY
  • NPI 1295188357
  NPD

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1306435664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 SOUTHSIDE AVE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117951420",
            "telephone_number": "516-592-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 SOUTHSIDE AVE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117951420",
            "telephone_number": "516-592-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTAUZZI",
        "first_name": "SAMANTHA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "098990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gavin Eysler, MD
• Rose Nkoli Ezeani, NP
• Facelipsteeth, Inc
• Laura Ann Falkowski, D.O.
• Eric Fanaee, MD
• Katie Fargnoli
• Sumaiya Farah Fatima
• Julia Elizabeth Favazzo, DO
• Kathleen K Febos, PT
• Catherine Joy Feliciano

• Clinical Social Worker in West Islip, NY
• Providers in West Islip, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.

Verify at the official NPI Registry.