Individual provider Active NPI

Christine Gattuso, LCSW-R

  • Clinical Social Worker
  • New Paltz, NY
National Provider Identifier
1417036609
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R059551-1 Issued in NY
Practice address
521 Main St
New Paltz, NY 12561-1609
Phone
(845) 392-6670
Fax
(845) 795-5850
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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 R059551-1 NY Primary

Addresses

Primary practice location

521 Main St
New Paltz, NY 12561-1609

Mailing address

705 Lattintown Rd
Milton, NY 12547-5311
Phone (845) 392-6670

Other identifiers 4

IdentifierTypeStateIssuer
R059551-1OtherNYLCSW-R LICENSE NUMBER
02314318MedicaidNY
1437562816OtherNYGROUP
1417036607OtherNYINDIVIDUAL NPI

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
I20110331000476 NY Practitioner - Clinical Social Worker 7810170644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

521 Main St
New Paltz, NY 12561-1609
Phone (845) 663-3830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R059551-1NYMDClinical Social Worker
059551NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Christine Gattuso, LCSW PLLC Clinical CurrentSince Sep 23, 2016 Accepting new patients

Locations

521 Main St
New Paltz, NY 12561
Phone (845) 242-5214

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1417036609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 LATTINTOWN RD",
            "city": "MILTON",
            "state": "NY",
            "postal_code": "125475311",
            "telephone_number": "845-392-6670",
            "fax_number": "845-795-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 MAIN ST",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611609",
            "telephone_number": "845-392-6670",
            "fax_number": "845-795-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATTUSO",
        "first_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R059551-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW-R LICENSE NUMBER",
            "identifier": "R059551-1",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02314318",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP",
            "identifier": "1437562816",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1417036607",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Paltz, NY

Sources for this page

Verify at the official NPI Registry.