Individual provider Active NPI

Joseph Tristan, LCSW

  • Clinical Social Worker
  • Binghamton, NY
National Provider Identifier
1366966483
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
091382 Issued in NY
Practice address
76 Broad Ave
Binghamton, NY 13904-1406
Phone
(607) 275-4488
NPI assigned
Jul 31, 2017
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 101156 NY
Clinical Social Worker 1041C0700X 091382 NY Primary

Addresses

Primary practice location

76 Broad Ave
Binghamton, NY 13904-1406

Mailing address

76 Broad Ave
Binghamton, NY 13904-1406

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
I20190404000614 NY Practitioner - Clinical Social Worker 6204177017 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
United Health Services Hospitals, Inc. CurrentSince Feb 23, 2019 Accepting new patients

Locations

10-42 Mitchell Ave
#1
Binghamton, NY 13903
Phone (607) 762-2990

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

33 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2340

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, 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": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1366966483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 BROAD AVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139041406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 BROAD AVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139041406",
            "telephone_number": "607-275-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRISTAN",
        "first_name": "JOSEPH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "101156",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.