Individual provider Active NPI

Connie Ann Christin Lobalsamo-Sorbie, LMSW

  • Clinical Social Worker
  • Shirley, NY
National Provider Identifier
1407031776
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO79835-01 Issued in NY
Practice address
28 Windus Dr
Shirley, NY 11967-2706
Phone
(631) 657-3586
NPI assigned
Jan 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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 RO79835-01 NY Primary

Addresses

Primary practice location

28 Windus Dr
Shirley, NY 11967-2706

Mailing address

28 Windus Dr
Shirley, NY 11967-2706
Phone (631) 657-3586

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
I20130213000470 NY Practitioner - Clinical Social Worker 2466606793 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as group
Quality
80.43
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO79835-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Ufko, LCSW, PLLC Clinical CurrentSince Apr 16, 2024 Accepting new patients
Supportive Care Psychology of Ny PC CurrentSince Aug 15, 2024 Accepting new patients
Allied Professional Partners SLP & Psychology PLLC PastSince Dec 1, 2012 Accepting new patients
Shine Medical PC Past Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

7810 164th St
Fresh Meadows, NY 11366
Phone (718) 429-2200

111 Smithtown Byp
Ste 207
Hauppauge, NY 11788
Phone (631) 360-3752

318 S Albany St
Ithaca, NY 14850
Phone (607) 273-4166

170 Lake St
Liberty, NY 12754
Phone (845) 292-4200

330 Chestnut St
Oneonta, NY 13820
Phone (607) 432-8500

Organizations & group practices 4

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": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1407031776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 WINDUS DR",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672706",
            "telephone_number": "631-657-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 WINDUS DR",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672706",
            "telephone_number": "631-657-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOBALSAMO-SORBIE",
        "first_name": "CONNIE",
        "middle_name": "ANN CHRISTIN",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO79835-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

Sources for this page

Verify at the official NPI Registry.