Individual provider Active NPI

Amanda Vassallo, LCSW

  • Clinical Social Worker
  • Yonkers, NY
National Provider Identifier
1346398930
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076434 Issued in NY
Practice address
487 S Broadway # 220
C/O WJCS
Yonkers, NY 10705-3269
Phone
(914) 423-4433
Fax
(914) 423-9434
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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 076434 NY Primary

Addresses

Primary practice location

487 S Broadway # 220
C/O WJCS
Yonkers, NY 10705-3269

Mailing address

487 S Broadway # 220
C/O WJCS
Yonkers, NY 10705-3269
Phone (914) 423-4433

Other names 1

  • Ms. Amanda Rosenberg Former name

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
I20090821000271 NY Practitioner - Clinical Social Worker 0143374363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

487 S Broadway
Suite 220
Yonkers, NY 10705-3269

845 N Broadway
White Plains, NY 10603-2427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
076434NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Jewish Community Services Inc. CurrentSince Jul 9, 2009 Accepting new patients

Locations

141 N Central Ave
Hartsdale, NY 10530
Phone (914) 949-6761

845 N Broadway
White Plains, NY 10603

487 S Broadway
#220
Yonkers, NY 10705
Phone 9144234433 ext. 49

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1346398930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "487 S BROADWAY # 220",
            "address_2": "C/O WJCS",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107053269",
            "telephone_number": "914-423-4433",
            "fax_number": "914-423-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "487 S BROADWAY # 220",
            "address_2": "C/O WJCS",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107053269",
            "telephone_number": "914-423-4433",
            "fax_number": "914-423-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSALLO",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ROSENBERG",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.