Roxana Marisol Servellon, LCSW, CASAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

084222 Issued in NY

Practice address

15 Bryant Ave
Roslyn, NY 11576-1134

Phone

(516) 547-8610

NPI assigned

Oct 30, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment Care Compare group NPD
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1477958676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BRYANT AVE",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761134",
            "telephone_number": "516-547-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BRYANT AVE",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761134",
            "telephone_number": "516-547-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVELLON",
        "first_name": "ROXANA",
        "middle_name": "MARISOL",
        "name_prefix": "Miss",
        "credential": "LCSW, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "2-22379",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamma Seeparsaud, COTA
• Kelliana Seeraj
• Eugene Segall, M.D.
• Lydia Seggev, PHD
• Scott J Sequeira, M.D.
• Ashish Seth, P.A.
• Sonika Seth
• Charles Daniel Severance, PA-C
• Alan Sezer, DDS
• SG Senior Living, LLC

• Clinical Social Worker in Roslyn, NY
• Providers in Roslyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.