Individual provider Active NPI

Laura Moran, MSW

  • Social Worker
  • Massapequa, NY
National Provider Identifier
1467852970
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
75 Grand Ave
Massapequa, NY 11758-4905
Phone
(516) 799-3203
Fax
(516) 799-3081
NPI assigned
Sep 3, 2014
Last updated
Apr 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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 NU Primary

Addresses

Primary practice location

75 Grand Ave
Massapequa, NY 11758-4905

Mailing address

75 Grand Ave
Massapequa, NY 11758-4905
Phone (516) 799-3203

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
I20190321001686 NY Practitioner - Clinical Social Worker 1254671647 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Psychology, P.C. CurrentSince Mar 1, 2019 Accepting new patients
Skypiatrist Psychiatry, PLLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

109 N 12th St
Ste 704
Brooklyn, NY 11249
Phone (347) 378-3144

123 Grove Ave
Ste 216
Cedarhurst, NY 11516
Phone (516) 569-5200

165 N Village Ave
Ste 12
Rockville Ctr, NY 11570
Phone (516) 594-2111

Organizations & group practices 2

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": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1467852970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 GRAND AVE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117584905",
            "telephone_number": "516-799-3203",
            "fax_number": "516-799-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 GRAND AVE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117584905",
            "telephone_number": "516-799-3203",
            "fax_number": "516-799-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "LAURA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.