Individual provider Active NPI

Donald R Sibley Jr., LCSW-R

  • Social Worker
  • Binghamton, NY
National Provider Identifier
1497193445
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
087178-1 Issued in NY
Practice address
76 Broad Ave
Binghamton, NY 13904-1406
Phone
(607) 237-0005
Fax
(607) 217-4253
NPI assigned
Jun 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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 087178-1 NY Primary

Addresses

Primary practice location

76 Broad Ave
Binghamton, NY 13904-1406

Mailing address

76 Broad Ave
Binghamton, NY 13904-1406
Phone (607) 237-0005

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
I20180223001421 NY Practitioner - Clinical Social Worker 5698036150 Reassigns benefits to 1 organization
Practice locations: Johnson City, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

435 Main St
Suite 113B
Johnson City, NY 13790-1931
Phone (607) 621-7183

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
087178-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
United Health Services Hospitals, Inc. CurrentSince Jan 2, 2018 Accepting new patients
United Medical Associates PC Past Accepting new patients

Locations

33 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2340

10-42 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2468

346 Grand Ave
Johnson City, NY 13790
Phone (607) 729-8156

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1497193445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 BROAD AVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139041406",
            "telephone_number": "607-237-0005",
            "fax_number": "607-217-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 BROAD AVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139041406",
            "telephone_number": "607-237-0005",
            "fax_number": "607-217-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBLEY",
        "first_name": "DONALD",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "087178-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.