Individual provider Active NPI

Andrea K M Smoller, L.C.S.W.

  • Social Worker
  • Greenlawn, NY
National Provider Identifier
1447583091
Registry record updated Sep 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
R025422-1 Issued in NY
Practice address
270 Pulaski Road
Suite D
Greenlawn, NY 11740
Phone
(631) 427-6060
Fax
(631) 549-4858
NPI assigned
Sep 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X R025422-1 NY Primary

Addresses

Primary practice location

270 Pulaski Road
Suite D
Greenlawn, NY 11740

Mailing address

270 Pulaski Road
Suite D
Greenlawn, NY 11740
Phone (631) 427-6060

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
I20091118000331 NY Practitioner - Clinical Social Worker 6103964804 Practice locations: Huntington, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

75 Prospect St
Suite 202
Huntington, NY 11743-3310
Phone (516) 901-7179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R025422-1NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252972800000",
    "number": "1447583091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 PULASKI ROAD",
            "address_2": "SUITE D",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "11740",
            "telephone_number": "631-427-6060",
            "fax_number": "631-549-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 PULASKI ROAD",
            "address_2": "SUITE D",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "11740",
            "telephone_number": "631-427-6060",
            "fax_number": "631-549-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLLER",
        "first_name": "ANDREA",
        "middle_name": "K M",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "R025422-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenlawn, NY

Sources for this page

Verify at the official NPI Registry.