Individual provider Active NPI

Heiko Ganzer, LCSW-R

  • Clinical Social Worker
  • Rocky Point, NY
National Provider Identifier
1316990732
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R055707 Issued in NY
Practice address
4 Neptune Rd
Rocky Point, NY 11778-9623
Phone
(631) 744-3108
Fax
(631) 849-6429
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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 R055707 NY Primary

Addresses

Primary practice location

4 Neptune Rd
Rocky Point, NY 11778-9623

Mailing address

4 Neptune Rd
Rocky Point, NY 11778-9623
Phone (631) 744-3108

Other identifiers 10

IdentifierTypeStateIssuer
346531OtherNYMHN
7370072OtherNYAETNA
7483430OtherNYGHI
7483430OtherNYVALUE OPTIONS
055707OtherNYHIP
N5J732OtherNYEMPIRE BC/BS
02397822MedicaidNY
0239782204MedicaidNY
P1119530OtherNYOXFORD
1060287EFOtherNYCIGNA BEHAVORAL HEALTH

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
I20120106000019 NY Practitioner - Clinical Social Worker 9032385406 Practice locations: Rocky Point, 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)

4 Neptune Rd
Rocky Point, NY 11778-9623
Phone (631) 744-3108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R055707NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Money Addictions of America LLC Clinical CurrentSince May 14, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1316990732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 NEPTUNE RD",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117789623",
            "telephone_number": "631-744-3108",
            "fax_number": "631-849-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 NEPTUNE RD",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117789623",
            "telephone_number": "631-744-3108",
            "fax_number": "631-849-6429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANZER",
        "first_name": "HEIKO",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R055707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "346531",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7370072",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7483430",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "7483430",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "055707",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS",
            "identifier": "N5J732",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02397822",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0239782204",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1119530",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVORAL HEALTH",
            "identifier": "1060287EF",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Point, NY

Sources for this page

Verify at the official NPI Registry.