Active NPI
Kai Stoll
- Clinical Social Worker
- Wantagh, NY
National Provider Identifier
1407332042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 094558
- Practice address
- 34 Willowood Dr
Wantagh, NY 11793-1217 - Phone
- (516) 532-8889
- NPI assigned
- Jul 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 094558 | NY | Primary |
| Social Worker | 104100000X | NY |
Addresses
Primary practice location
34 Willowood Dr
Wantagh, NY 11793-1217
Mailing address
34 Willowood Dr
Wantagh, NY 11793-1217
Phone (516) 532-8889
Other practice location 1
114 Church St
Freeport, NY 11520-3833
Phone (516) 868-3030 ext. 2242
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 094558 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Shore Child Association Incorporated | Current | Accepting new patients | |
| Epilepsy Foundation of L.I. | Current | Accepting new patients | |
| Epic Long Island | Current | Accepting new patients | |
| South Shore Child Association Incorporated | Current | Accepting new patients |
Locations
1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420
114 Church St
Freeport, NY 11520
Phone (516) 868-3030
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.
-
- Voluntary or Charitable Agency
- East Meadow, NY
- NPI 1174563936
-
- Community/Behavioral Health Agency
- Freeport, NY
- NPI 1023154507
-
- Voluntary or Charitable Agency
- Garden City, NY
- NPI 1467755785
-
- Case Management Agency
- Freeport, NY
- NPI 1205972601
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1407332042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 WILLOWOOD DR",
"city": "WANTAGH",
"state": "NY",
"postal_code": "117931217",
"telephone_number": "516-532-8889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 WILLOWOOD DR",
"city": "WANTAGH",
"state": "NY",
"postal_code": "117931217",
"telephone_number": "516-532-8889"
}
],
"practiceLocations": [
{
"address_1": "114 Church St",
"address_purpose": "LOCATION",
"city": "Freeport",
"state": "NY",
"postal_code": "115203833",
"country_code": "US",
"telephone_number": "516-868-3030 x2242",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STOLL",
"first_name": "KAI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-17",
"last_updated": "2024-06-18",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "094558",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wantagh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.