Individual provider Active NPI

Alyson Rose Koonin, MSW

  • Clinical Social Worker
  • Rego Park, NY
National Provider Identifier
1407262991
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
9729 64TH Rd
Rego Park, NY 11374-2259
Phone
(718) 896-3400
Fax
(718) 897-2666
NPI assigned
Jul 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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 Primary

Addresses

Primary practice location

9729 64TH Rd
Rego Park, NY 11374-2259

Mailing address

9729 64TH Rd
Rego Park, NY 11374-2259
Phone (718) 896-3400

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
I20191218002953 NY Practitioner - Clinical Social Worker 7315371689 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Consultation Center CurrentSince Aug 15, 2021 Accepting new patients
Lana Gaiton Psychological Services, PC CurrentSince Nov 12, 2024 Accepting new patients

Locations

2502 86th St
Fl 3
Brooklyn, NY 11214
Phone (347) 391-4205

9131 Queens Blvd
Ste 222
Elmhurst, NY 11373
Phone (718) 896-3400

11247 Queens Blvd
Forest Hills, NY 11375
Phone (347) 391-4250

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

Organizations & group practices 2

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": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404691200000",
    "number": "1407262991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9729 64TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742259",
            "telephone_number": "718-896-3400",
            "fax_number": "718-897-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9729 64TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742259",
            "telephone_number": "718-896-3400",
            "fax_number": "718-897-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONIN",
        "first_name": "ALYSON",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.