Kaya Petra Sanderson, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

090703-1 Issued in NY

Practice address

905 Greene County Office BLDG
Cairo, NY 12413-2868

Phone

(518) 622-9163

Fax

(518) 622-8592

NPI assigned

Nov 13, 2013

Last updated

Nov 13, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1384300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1356771273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 GREENE COUNTY OFFICE BLDG",
            "city": "CAIRO",
            "state": "NY",
            "postal_code": "124132868",
            "telephone_number": "518-622-9163",
            "fax_number": "518-622-8592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 GREENE COUNTY OFFICE BLDG",
            "city": "CAIRO",
            "state": "NY",
            "postal_code": "124132868",
            "telephone_number": "518-622-9163",
            "fax_number": "518-622-8592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "KAYA",
        "middle_name": "PETRA",
        "name_prefix": "Miss",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-13",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "090703-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katiana Isabell Pieri, L.AC , DACM
• Susan L Pisarri, RN
• Courtney Ann Porlier, LCSW
• Darcy A Rossignol, LCSW
• Maureen Russo, LCSW
• Ellen L Schoonover, N.P.
• Jennifer Lyn Schultz
• Patricia J Seymour, RN
• Aisia Shackelford
• Stephanie Brooke Shaul, LCSW

• Social Worker in Cairo, NY
• Providers in Cairo, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.