Individual provider Active NPI

Sam Sobel, LCSW

  • Social Worker
  • Briarwood, NY
National Provider Identifier
1487757621
Registry record updated Nov 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
045513 Issued in NY
Practice address
13876 Queens Blvd FL 1
Briarwood, NY 11435-2930
Phone
(718) 850-3645
Fax
(718) 526-7971
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2009

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 045513 NY Primary

Addresses

Primary practice location

13876 Queens Blvd FL 1
Briarwood, NY 11435-2930

Mailing address

13876 Queens Blvd FL 1
Briarwood, NY 11435-2930
Phone (718) 850-3645

Other identifiers 3

IdentifierTypeStateIssuer
0256FVOtherNYMEDICARE GHI
7479547OtherGHI
P1971101OtherOXFORD

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
I20040708001350 NY Practitioner - Clinical Social Worker 2860470663 Practice locations: Forest Hills, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7613 113TH St
1F
Forest Hills, NY 11375-6597
Phone (718) 790-6211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045513NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Counseling LCSW, PLLC CurrentSince Mar 1, 2008 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1487757621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13876 QUEENS BLVD FL 1",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114352930",
            "telephone_number": "718-850-3645",
            "fax_number": "718-526-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13876 QUEENS BLVD FL 1",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114352930",
            "telephone_number": "718-850-3645",
            "fax_number": "718-526-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBEL",
        "first_name": "SAM",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "045513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GHI",
            "identifier": "0256FV",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7479547",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1971101",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Briarwood, NY

Sources for this page

Verify at the official NPI Registry.