Active NPI
Brandon Tosov, LCSW
- Clinical Social Worker
- Smithtown, NY
National Provider Identifier
1427426253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 090959
- Practice address
- 24 Bellemeade Ave Ste 24-102
Smithtown, NY 11787-1855 - Phone
- (631) 317-4079
- NPI assigned
- Sep 10, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Social Worker | 104100000X | 099048-1 | NY | |
| Clinical Social Worker | 1041C0700X | 090959 | NY | Primary |
Addresses
Primary practice location
24 Bellemeade Ave Ste 24-102
Smithtown, NY 11787-1855
Mailing address
865 Broadway Ave Apt 201B
Holbrook, NY 11741-4946
Phone (631) 317-4079
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220822000120 | NY | Practitioner - Clinical Social Worker | 2769865922 | Practice locations: Smithtown, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- State University of New York at Stony Brook, School of Medicine, 2016
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
24 Bellemeade Ave
Suite 24 102
Smithtown, NY 11787-1855
Phone (631) 317-4079
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 099048-1 | NY | MD | Social Worker |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655942400000",
"number": "1427426253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "865 BROADWAY AVE APT 201B",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117414946",
"telephone_number": "631-317-4079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 BELLEMEADE AVE STE 24-102",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117871855",
"telephone_number": "631-317-4079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOSOV",
"first_name": "BRANDON",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-10",
"last_updated": "2022-06-23",
"certification_date": "2022-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "099048-1",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "090959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.