Individual provider Active NPI

Thomas Joseph Giancarlo, MSW, LCSW

  • Clinical Social Worker
  • Buffalo, NY
National Provider Identifier
1326014713
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR017949-1 Issued in NY
Practice address
1631 Hertel Ave
Buffalo, NY 14216-2908
Phone
(716) 833-8800
Fax
(716) 876-5730
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
Yes

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 PR017949-1 NY Primary

Addresses

Primary practice location

1631 Hertel Ave
Buffalo, NY 14216-2908

Mailing address

108 Saranac Ave
Buffalo, NY 14216-2443
Phone (716) 833-8800

Other identifiers 1

IdentifierTypeStateIssuer
02147946MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
PR017949-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Church Mission of Help of Western New York Inc PastSince Sep 20, 2004 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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326014713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 SARANAC AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162443",
            "telephone_number": "716-833-8800",
            "fax_number": "716-876-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 HERTEL AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162908",
            "telephone_number": "716-833-8800",
            "fax_number": "716-876-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIANCARLO",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR017949-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02147946",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.