Individual provider Active NPI

Ivy Lisa Giller, LCSW

  • Clinical Social Worker
  • Roslyn, NY
National Provider Identifier
1447405006
Registry record updated Nov 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO36057-1 Issued in NY
Practice address
153 Main St
Roslyn, NY 11576-2250
Phone
(516) 625-5863
Fax
(516) 484-0388
NPI assigned
Nov 24, 2008
Last updated
Nov 24, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2008

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 RO36057-1 NY Primary

Addresses

Primary practice location

153 Main St
Roslyn, NY 11576-2250

Mailing address

153 Main St
Roslyn, NY 11576-2250
Phone (516) 625-5863

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
I20100428000015 NY Practitioner - Clinical Social Worker 8022145812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1959 Monroe Ave
North Bellmore, NY 11710-1520
Phone (516) 826-4891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO36057-1NYMDClinical Social Worker
036057NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Guidance Counseling & Licensed Clinical Social Work Services PC Clinical CurrentSince Mar 4, 2010 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227484800000",
    "number": "1447405006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 MAIN ST",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115762250",
            "telephone_number": "516-625-5863",
            "fax_number": "516-484-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 MAIN ST",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115762250",
            "telephone_number": "516-625-5863",
            "fax_number": "516-484-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLER",
        "first_name": "IVY",
        "middle_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-24",
        "last_updated": "2008-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO36057-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

Verify at the official NPI Registry.