Samuel R Taube, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW R030704 Issued in NY

Practice address

139-B Main St.
Stony Brook, NY 11790-0507

Phone

(631) 751-5191

Fax

(631) 751-1860

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 27, 2015 through Jan 27, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346322807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139-B MAIN ST.",
            "address_2": "P.O. BOX 507",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900507",
            "telephone_number": "631-751-5191",
            "fax_number": "631-751-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139-B MAIN ST.",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900507",
            "telephone_number": "631-751-5191",
            "fax_number": "631-751-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUBE",
        "first_name": "SAMUEL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "LCSW R030704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Vincent Tanzi, MD
• Veronica Gabriela Tapia, M.D.
• Victor Tarsia, M.D.
• Apostolos Tassiopoulos, M.D.
• Vahe S Tateosian, M.D.
• Erin V Taveras, RPA-C
• Felix Bernard Tavernier, M.D.
• Suzanne Marie Tawch, DO
• George-Abraam Nasser Tawfik, MD
• James Roy Taylor Jr., M.D.

• Clinical Social Worker in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Clinical Social Worker in New York

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.