Individual provider Active NPI

Evan M Michaels, LCSW

  • Clinical Social Worker
  • Merrick, NY
National Provider Identifier
1417022658
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R047298-1 Issued in NY
Practice address
31 Merrick Ave
Suite 110
Merrick, NY 11566-3477
Phone
(917) 576-0720
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R047298-1 NY Primary

Addresses

Primary practice location

31 Merrick Ave
Suite 110
Merrick, NY 11566-3477

Mailing address

228 Frankel Blvd
Merrick, NY 11566-4732
Phone (917) 576-0720

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
I20060502000904 NY Practitioner - Clinical Social Worker 8729098900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2116 Merrick Ave
Suite 2001
Merrick, NY 11566-3409
Phone (917) 576-0720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R047298-1NYMDClinical Social Worker
047298NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Evan Michaels LCSW PC Clinical CurrentSince Jan 25, 2022 Accepting new patients

Locations

2116 Merrick Ave
Ste 2001
Merrick, NY 11566
Phone (516) 226-0423

Organizations & group practices 1

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417022658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 FRANKEL BLVD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664732",
            "telephone_number": "917-576-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 MERRICK AVE",
            "address_2": "SUITE 110",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115663477",
            "telephone_number": "917-576-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELS",
        "first_name": "EVAN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R047298-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

Verify at the official NPI Registry.