Individual provider Active NPI

Collin Quammie, LCSW-R

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1427203777
Registry record updated Jan 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0457411 Issued in NY
Practice address
350 Central Park W
Apt 1F
New York, NY 10025-6547
Phone
(917) 301-5654
Fax
(914) 674-0624
NPI assigned
Nov 28, 2008
Last updated
Jan 21, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2012

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 R0457411 NY Primary

Addresses

Primary practice location

350 Central Park W
Apt 1F
New York, NY 10025-6547

Mailing address

26 Jennifer LN
Hartsdale, NY 10530-1218
Phone (914) 674-0624

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
I20090828000347 NY Practitioner - Clinical Social Worker 1052466976 Reassigns benefits to 1 organization
Practice locations: New Rochelle, NY; New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrity Social Work Services LLCGroup PAC ID 4880609528, 74 clinicians

Practice addresses (Care Compare)

46 Francesca LN
Staten Island, NY 10303-2101
Phone (718) 494-2858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0457411NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The New York and Presbyterian Hospital Past Accepting new patients
The Mental Health Association of Westchester County - Social Care Network Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1227830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327104000000",
    "number": "1427203777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 JENNIFER LN",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301218",
            "telephone_number": "914-674-0624",
            "fax_number": "914-674-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 CENTRAL PARK W",
            "address_2": "APT 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256547",
            "telephone_number": "917-301-5654",
            "fax_number": "914-674-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAMMIE",
        "first_name": "COLLIN",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-28",
        "last_updated": "2012-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0457411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.