Individual provider Active NPI

Pamela J Coffey-Marceau, LCSW-R

  • Clinical Social Worker
  • East Syracuse, NY
National Provider Identifier
1467536482
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R047360-1 Issued in NY
Practice address
5008 Brittonfield Pkwy Ste 700
East Syracuse, NY 13057
Phone
(315) 472-7504
Fax
(315) 634-4677
NPI assigned
Oct 25, 2006
Last updated
Aug 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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 R047360-1 NY Primary

Addresses

Primary practice location

5008 Brittonfield Pkwy Ste 700
East Syracuse, NY 13057

Mailing address

5008 Brittonfield Pkwy Ste 700
East Syracuse, NY 13057-9249
Phone (315) 472-7504

Other identifiers 1

IdentifierTypeStateIssuer
R047360OtherNYNYS LICENSE

Other names 1

  • Pamela J Coffey Former name

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
I20040927000360 NY Practitioner - Clinical Social Worker 1153390265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hematology-Oncology Associates of Cny, PCGroup PAC ID 6709787823, 65 clinicians

Practice addresses (Care Compare)

5008 Brittonfield Pkwy
East Syracuse, NY 13057-9248
Phone (315) 472-7504

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R047360-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hematology-Oncology Associates of Cny, PC Clinical CurrentSince Apr 22, 2018 Accepting new patients
Buffalo Centre for the Treatment of Eating Disorders Past Accepting new patients
Centre Syracuse, LLC Past Accepting new patients

Locations

5008 Brittonfield Pkwy
East Syracuse, NY 13057
Phone (315) 634-5056

5008 Brittonfield Pkwy
Ste 700
East Syracuse, NY 13057

Organizations & group practices 3

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1467536482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY STE 700",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579249",
            "telephone_number": "315-472-7504",
            "fax_number": "315-634-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY STE 700",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "315-472-7504",
            "fax_number": "315-634-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFEY-MARCEAU",
        "first_name": "PAMELA",
        "middle_name": "J",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R047360-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "R047360",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "COFFEY",
            "middle_name": "J",
            "credential": "LCSW-R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.