Individual provider Active NPI

Jeanine H Goldsmith, LCSW

  • Clinical Social Worker
  • Deer Park, NY
National Provider Identifier
1336257401
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
072309 Issued in NY
Practice address
2070 Deer Park Ave
Ste D
Deer Park, NY 11729-2134
Phone
(631) 522-1888
Fax
(631) 522-1889
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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 072309 NY Primary

Addresses

Primary practice location

2070 Deer Park Ave
Ste D
Deer Park, NY 11729-2134

Mailing address

56 Cedar Dr
Farmingdale, NY 11735-2902
Phone (631) 833-1700

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
I20070719000728 NY Practitioner - Clinical Social Worker 4789785841 Practice locations: North Babylon, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1301 Deer Park Ave
North Babylon, NY 11703-2728
Phone (631) 522-1888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
072309NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Linda J Smith LCSW PLLC Clinical PastSince Mar 8, 2017 Accepting new patients

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1336257401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 CEDAR DR",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117352902",
            "telephone_number": "631-833-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 DEER PARK AVE",
            "address_2": "STE D",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292134",
            "telephone_number": "631-522-1888",
            "fax_number": "631-522-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSMITH",
        "first_name": "JEANINE",
        "middle_name": "H",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "072309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

Verify at the official NPI Registry.