Individual provider Active NPI

Patricia F Coyle, DSW

  • Clinical Social Worker
  • Centerport, NY
National Provider Identifier
1467518951
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR024620-1 Issued in NY
Practice address
115 Centershore Rd
Centerport, NY 11721-1346
Phone
(631) 261-9445
Fax
(631) 754-7603
NPI assigned
Dec 29, 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 PR024620-1 NY Primary

Addresses

Primary practice location

115 Centershore Rd
Centerport, NY 11721-1346

Mailing address

115 Centershore Rd
Centerport, NY 11721-1346
Phone (631) 261-9445

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
I20120409000050 NY Practitioner - Clinical Social Worker 1456512060 Practice locations: Centerport, 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

Practice addresses (Care Compare)

115 Centershore Rd
Centerport, NY 11721-1346
Phone (631) 261-9445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR024620-1NYMDClinical Social Worker
024620NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467518951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CENTERSHORE RD",
            "city": "CENTERPORT",
            "state": "NY",
            "postal_code": "117211346",
            "telephone_number": "631-261-9445",
            "fax_number": "631-754-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CENTERSHORE RD",
            "city": "CENTERPORT",
            "state": "NY",
            "postal_code": "117211346",
            "telephone_number": "631-261-9445",
            "fax_number": "631-754-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "PATRICIA",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR024620-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerport, NY

Sources for this page

Verify at the official NPI Registry.