Individual provider Active NPI

Lauren Peffer

  • Clinical Social Worker
  • Bath, NY
National Provider Identifier
1316165566
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R069412-1 Issued in NY
Practice address
115 Liberty St
Bath, NY 14810-1508
Phone
(607) 776-6577
NPI assigned
Apr 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 R069412-1 NY Primary

Addresses

Primary practice location

115 Liberty St
Bath, NY 14810-1508

Mailing address

115 Liberty St
Bath, NY 14810-1508
Phone (607) 776-6577

Other identifiers 1

IdentifierTypeStateIssuer
00060644MedicaidNY

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
I20200102001030 NY Practitioner - Clinical Social Worker 4082048814 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Pathways, Inc.Group PAC ID 7416329008, 18 clinicians

Practice addresses (Care Compare)

77 E 1St St
Corning, NY 14830-2715
Phone (607) 936-1771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R069412-1NYMDClinical Social Worker
069412NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways, Inc. CurrentSince Sep 22, 2019 Accepting new patients
Erwin Psychiatric NP PLLC CurrentSince Mar 24, 2024 Accepting new patients

Locations

33 Denison Pkwy W
Corning, NY 14830
Phone (607) 937-3200

77 E 1st St
Corning, NY 14830
Phone (607) 936-1771

Organizations & group practices 2

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316165566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LIBERTY ST",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148101508",
            "telephone_number": "607-776-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LIBERTY ST",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148101508",
            "telephone_number": "607-776-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEFFER",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R069412-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00060644",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, NY

Sources for this page

Verify at the official NPI Registry.