Individual provider Active NPI

Bryan David Epel, LCSW

  • Clinical Social Worker
  • Verplanck, NY
National Provider Identifier
1356619910
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
080817 Issued in NY
Practice address
151 6TH St Unit 287
Verplanck, NY 10596-7735
Phone
(516) 400-2766
NPI assigned
Dec 9, 2011
Last updated
Dec 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 080817 CT
Clinical Social Worker 1041C0700X 080817 PA
Clinical Social Worker 1041C0700X 080817 NJ
Clinical Social Worker 1041C0700X 080817 NY Primary

Addresses

Primary practice location

151 6TH St Unit 287
Verplanck, NY 10596-7735

Mailing address

151 6TH St Unit 287
Verplanck, NY 10596-7735
Phone (516) 425-3241

Other identifiers 1

IdentifierTypeStateIssuer
1831721422MedicaidNY

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
I20120220000715 NY Practitioner - Clinical Social Worker 5799943916 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
080817CTMDClinical Social Worker
080817NJMDClinical Social Worker
080817PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Center Inc CurrentSince Jun 25, 2023 Accepting new patients
Family Center Inc Community/Behavioral Health CurrentSince Jun 25, 2019 Accepting new patients
The Child Center of Ny, Inc. CurrentSince Sep 9, 2017 Accepting new patients
Shine Medical PC Past Accepting new patients

Locations

493 Nostrand Ave
Ste 3
Brooklyn, NY 11216
Phone (718) 230-1379

14015 Sanford Ave
Ste B
Flushing, NY 11355
Phone (718) 450-9242

11835 Queens Blvd
Fl 6
Forest Hills, NY 11375
Phone (718) 851-7770

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1356619910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 6TH ST UNIT 287",
            "city": "VERPLANCK",
            "state": "NY",
            "postal_code": "105967735",
            "telephone_number": "516-425-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 6TH ST UNIT 287",
            "city": "VERPLANCK",
            "state": "NY",
            "postal_code": "105967735",
            "telephone_number": "516-400-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPEL",
        "first_name": "BRYAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-09",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "080817",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "080817",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "080817",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831721422",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Verplanck, NY

Sources for this page

Verify at the official NPI Registry.