Individual provider Active NPI

Jesse C Palermo, LCSW

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1407285893
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
085688 Issued in NY
Practice address
375 W Onondaga St
Suite 10
Syracuse, NY 13202-1888
Phone
(315) 478-2030
NPI assigned
Nov 6, 2013
Last updated
Mar 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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 44SL05878800 NJ
Clinical Social Worker 1041C0700X 085688 NY Primary

Addresses

Primary practice location

375 W Onondaga St
Suite 10
Syracuse, NY 13202-1888

Mailing address

375 W Onondaga St
Suite 10
Syracuse, NY 13202-1888
Phone (315) 478-2030

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
I20230407000854 NY Practitioner - Clinical Social Worker 2668808759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aldad Medical PCGroup PAC ID 9234291436, 78 clinicians

Practice addresses (Care Compare)

510 Hempstead Tpke
RM 203
West Hempstead, NY 11552-1152
Phone (516) 505-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL05878800NJMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aldad Medical PC CurrentSince Apr 1, 2023 Accepting new patients
Central New York Services Past Accepting new patients
Central New York Services Past Accepting new patients

Locations

27111 76th Ave
North New Hyde Pk, NY 11040
Phone (718) 289-2100

510 Hempstead Tpke
Rm 203
West Hempstead, NY 11552
Phone 51650572001051

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, 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": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1407285893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 W ONONDAGA ST",
            "address_2": "SUITE 10",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132021888",
            "telephone_number": "315-478-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 W ONONDAGA ST",
            "address_2": "SUITE 10",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132021888",
            "telephone_number": "315-478-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALERMO",
        "first_name": "JESSE",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-06",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05878800",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.