Individual provider Active NPI

Karen Sue Tukman, LCSW

  • Clinical Social Worker
  • Smithtown, NY
National Provider Identifier
1447339635
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0218781 Issued in NY
Practice address
363 Route 111 Ste 103
Smithtown, NY 11787-4750
Phone
(516) 459-1594
Fax
(631) 824-9137
NPI assigned
Nov 6, 2006
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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 R0218781 NY Primary

Addresses

Primary practice location

363 Route 111 Ste 103
Smithtown, NY 11787-4750

Mailing address

363 Route 111 Ste 103
Smithtown, NY 11787-4750
Phone (516) 459-1594

Other identifiers 3

IdentifierTypeStateIssuer
P2820353OtherNYOXFORD
054877OtherNYVALUE OPTIONS
7400014OtherNYGHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0218781NYMDClinical Social Worker
021878NYMDOccupational Therapist

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1447339635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 ROUTE 111 STE 103",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874750",
            "telephone_number": "516-459-1594",
            "fax_number": "318-249-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 ROUTE 111 STE 103",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874750",
            "telephone_number": "516-459-1594",
            "fax_number": "631-824-9137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUKMAN",
        "first_name": "KAREN",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0218781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2820353",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "054877",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7400014",
            "state": "NY"
        }
    ],
    "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 Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.