Individual provider Active NPI

Anna Nicole Capetola

  • Social Worker
  • New York, NY
National Provider Identifier
1407567167
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
115787 Issued in NY
Practice address
18 W 21St St
New York, NY 10010-6903
Phone
(516) 984-7108
NPI assigned
Dec 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 115787 NY Primary

Addresses

Primary practice location

18 W 21St St
New York, NY 10010-6903

Mailing address

12 Sunview Dr
Glen Cove, NY 11542-1731
Phone (516) 984-7108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
115787NYMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1407567167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SUNVIEW DR",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115421731",
            "telephone_number": "516-984-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 W 21ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106903",
            "telephone_number": "516-984-7108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPETOLA",
        "first_name": "ANNA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "115787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.