Individual provider Active NPI

Gaetano Scognamillo

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1427330471
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
71253 Issued in CA
Practice address
200 W 81St St
New York, NY 10024-5833
Phone
(212) 989-2990
Fax
(212) 792-6058
NPI assigned
Sep 15, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 71253 CA Primary

Addresses

Primary practice location

200 W 81St St
New York, NY 10024-5833

Mailing address

200 W 81St St
New York, NY 10024-5833
Phone (212) 989-2990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151103001914 NY Practitioner - Clinical Social Worker 2567772551 Reassigns benefits to 1 organization
I20200618000526 CA Practitioner - Clinical Social Worker 2567772551 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71253CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles LGBT Center CurrentSince Jun 3, 2020 Accepting new patients
Los Angeles LGBT Center Clinical CurrentSince Jun 3, 2020 Accepting new patients
The Fifth Avenue Counseling Center, Inc. CurrentSince Aug 28, 2015 Accepting new patients
Stanley R Graham PH D PC Past Accepting new patients
New York Association for New Americans, Inc PastSince May 1, 2008 Accepting new patients

Locations

1625 Schrader Blvd
Fl 3
Los Angeles, CA 90028
Phone (323) 993-7400

1625 Schrader Blvd
Los Angeles, CA 90028
Phone (323) 993-7400

5 E 17th St
Fl 2
New York, NY 10003
Phone (212) 989-2900

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1427330471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 81ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245833",
            "telephone_number": "212-989-2990",
            "fax_number": "212-792-6058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 81ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245833",
            "telephone_number": "212-989-2990",
            "fax_number": "212-792-6058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOGNAMILLO",
        "first_name": "GAETANO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-15",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "71253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.