Judith Damico

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LCSW R016472-1 Issued in NY

Practice address

903 Main St
Suite 202
Port Jefferson, NY 11777-2262

Phone

(631) 473-3060

Fax

(631) 751-2850

NPI assigned

Sep 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

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, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396842944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 MAIN ST",
            "address_2": "SUITE 202",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772262",
            "telephone_number": "631-473-3060",
            "fax_number": "631-751-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 MAIN ST",
            "address_2": "SUITE 202",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772262",
            "telephone_number": "631-473-3060",
            "fax_number": "631-751-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMICO",
        "first_name": "JUDITH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "LCSW R016472-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI, EMPIRE PLAN",
            "identifier": "74009640",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS",
            "identifier": "N61882",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "059761",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "02027003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH CARE",
            "identifier": "P1533264",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne D'Addona, LMSW
• Laura D'Andrea, LMSW
• Jonathan D'Costa
• Hadi Dahhan, DO
• Matthew Thomas Daly, OTR/L
• Yvon Damour, M.D.
• Ashley Daniel
• Stacy Danon, LMSW
• Arlene Darcy, P.T.A.
• David Anschel MD PC

• Social Worker in Port Jefferson, NY
• Providers in Port Jefferson, 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 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.
• 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.