Individual provider Active NPI

Ann L Goodstein, DSW

  • Clinical Social Worker
  • Smithtown, NY
National Provider Identifier
1447321500
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PRO26295 Issued in NY
Practice address
180 E Main St
Suite 202
Smithtown, NY 11787-2888
Phone
(631) 360-3535
Fax
(631) 360-1394
NPI assigned
Nov 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PRO26295 NY Primary

Addresses

Primary practice location

180 E Main St
Suite 202
Smithtown, NY 11787-2888

Mailing address

180 E Main St
Suite 202
Smithtown, NY 11787-2888
Phone (631) 360-3535

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
I20050314001016 NY Practitioner - Clinical Social Worker 0446205397 Practice locations: Smithtown, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

21 Redwood Lane
Smithtown, NY 11787-2718

21 Redwood LN
Smithtown, NY 11787-2718
Phone (631) 360-3535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PRO26295NYMDClinical Social Worker
026295NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447321500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 E MAIN ST",
            "address_2": "SUITE 202",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872888",
            "telephone_number": "631-360-3535",
            "fax_number": "631-360-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E MAIN ST",
            "address_2": "SUITE 202",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872888",
            "telephone_number": "631-360-3535",
            "fax_number": "631-360-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSTEIN",
        "first_name": "ANN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PRO26295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.