Daniel Peter Defalco III

Primary specialty

Social WorkerTaxonomy code 104100000X

License

094452-1 Issued in NY

Practice address

1125 Fulton St
Brooklyn, NY 11238-2669

Phone

(347) 226-9025

NPI assigned

Dec 9, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• New York Psychotherapy and Counseling Center

  • Community/Behavioral Health Agency
  • Jamaica, NY
  • NPI 1902811342
  Medicare reassignment NPD
• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)
• Sus Mental Health Programs, Inc.

  • Community/Behavioral Health Agency
  • Brooklyn, NY
  • NPI 1053696195
  NPD (past)

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1457062572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112382669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112382669",
            "telephone_number": "347-226-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFALCO",
        "first_name": "DANIEL",
        "middle_name": "PETER",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "094452-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deeply Rooted OT
• Deeply Rooted Therapeutic Services LCSW PLLC
• Clover Deer
• Orlette Deer
• Shanice Deer, LPN
• Gregory V Defazio, MD
• Mark L Defazio, MD
• Nicholas Defazio, LCSW
• Vita Defede
• Everett James Defieux, L.AC, LMT

• Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.