Individual provider Active NPI

Ruth E. Roberts, LCSW

  • Clinical Social Worker
  • Owego, NY
National Provider Identifier
1306991146
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R060068-1 Issued in NY
Practice address
1062 State Rte 38
Owego, NY 13827
Phone
(607) 687-0200
Fax
(607) 687-0248
NPI assigned
Jan 24, 2007
Last updated
Oct 1, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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 R060068-1 NY Primary

Addresses

Primary practice location

1062 State Rte 38
Owego, NY 13827

Mailing address

1062 State Route 38
PO Box 177
Owego, NY 13827-3209
Phone (607) 687-0200

Other identifiers 2

IdentifierTypeStateIssuer
R060068-1OtherNYLCSW LICENSE NUMBER
00618162MedicaidNY

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
I20110505000375 NY Practitioner - Clinical Social Worker 9436334513 Practice locations: Greene, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

29 N Chenango St
Greene, NY 13778-1154
Phone (607) 765-3829

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R060068-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1306991146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1062 STATE ROUTE 38",
            "address_2": "PO BOX 177",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "138273209",
            "telephone_number": "607-687-0200",
            "fax_number": "607-687-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1062 STATE RTE 38",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "13827",
            "telephone_number": "607-687-0200",
            "fax_number": "607-687-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "RUTH",
        "middle_name": "E.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R060068-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE NUMBER",
            "identifier": "R060068-1",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00618162",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owego, NY

Sources for this page

Verify at the official NPI Registry.