Individual provider Active NPI

Shimeon R Bellis, LCSW

  • Clinical Social Worker
  • New City, NY
National Provider Identifier
1336591312
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09541-1 Issued in NY
Practice address
2 Waverly CT
New City, NY 10956-2218
Phone
(240) 355-3015
NPI assigned
Jul 1, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2024

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 09541-1 NY Primary

Addresses

Primary practice location

2 Waverly CT
New City, NY 10956-2218

Mailing address

2 Waverly CT
New City, NY 10956-2218
Phone (240) 355-3015

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
I20240523001605 NY Practitioner - Clinical Social Worker 1456793355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrity Social Work Services LLCGroup PAC ID 4880609528, 74 clinicians

Practice addresses (Care Compare)

1110 S Ave
Suite 404
Staten Island, NY 10314-3411
Phone (800) 277-4680

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09541-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Social Work Services LLC Clinical CurrentSince Apr 2, 2024 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

Locations

1110 South Ave
Ste 404
Staten Island, NY 10314
Phone (718) 494-2858

2381 Hylan Blvd
Ste 13
Staten Island, NY 10306
Phone (718) 494-2858

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1336591312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WAVERLY CT",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109562218",
            "telephone_number": "240-355-3015",
            "fax_number": "347-331-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WAVERLY CT",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109562218",
            "telephone_number": "240-355-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLIS",
        "first_name": "SHIMEON",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-01",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "09541-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

Verify at the official NPI Registry.