Brian R Amidon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

083385 Issued in NY

Practice address

725 Irving Ave
Syracuse, NY 13210-1603

Phone

(315) 464-5538

Fax

(315) 464-5579

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Department of Medicine Medical Service Group

  • Hematology & Oncology Physician
  • Homer, NY
  • NPI 1205104262
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1417029026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE STE 302",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101603",
            "telephone_number": "315-464-5538",
            "fax_number": "315-464-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101603",
            "telephone_number": "315-464-5538",
            "fax_number": "315-464-5579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIDON",
        "first_name": "BRIAN",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "072991",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01649605",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Rose Amendola
• America'S Best Contacts & Eyeglasses
• American Anesthesiology of Syracuse, PC
• Lisa D Stone Ames
• Sarah Anne Ames, PA-C
• Deborah Lu Amidon, R.N.
• Siani Ym Amidon, M.S., C.A.S., NCSP
• Nibir Amin, MD
• Syed R Amins, MD
• Madhurya Sai Amirapu, MD

• Clinical Social Worker in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.

Verify at the official NPI Registry.