Individual provider Active NPI

Lisa A Fogel, LCSW

  • Clinical Social Worker
  • Pittsford, NY
National Provider Identifier
1427296342
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
075706-1 Issued in NY
Practice address
20 Office Park Way
Pittsford, NY 14534-1718
Phone
(585) 474-0356
NPI assigned
Jan 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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 075706-1 NY Primary

Addresses

Primary practice location

20 Office Park Way
Pittsford, NY 14534-1718

Mailing address

20 Office Park Way
Pittsford, NY 14534-1718
Phone (585) 244-8351

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
I20100204000000 NY Practitioner - Clinical Social Worker 7810030566 Reassigns benefits to 1 organization
Practice locations: Pittsford, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5 Falconbridge Dr
Pittsford, NY 14534-1016
Phone (585) 474-0356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
075706-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester Rehabilitation Center, Inc PastSince Aug 11, 2005 Accepting new patients

Organizations & group practices 2

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": "1233273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1427296342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 OFFICE PARK WAY",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145341718",
            "telephone_number": "585-244-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 OFFICE PARK WAY",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145341718",
            "telephone_number": "585-474-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGEL",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-30",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075706-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsford, NY

Sources for this page

Verify at the official NPI Registry.