Individual provider Active NPI

Naya Pyskacek, LICSW

  • Clinical Social Worker
  • South Burlington, VT
National Provider Identifier
1497710560
Registry record updated Apr 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0890000899 Issued in VT
Practice address
3 Baycrest Dr
South Burlington, VT 05403-7713
Phone
(802) 999-9999
NPI assigned
Apr 19, 2006
Last updated
Apr 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2019

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 0890000899 VT Primary

Addresses

Primary practice location

3 Baycrest Dr
South Burlington, VT 05403-7713

Mailing address

3 Baycrest Dr
South Burlington, VT 05403-7713
Phone (802) 999-9999

Other identifiers 6

IdentifierTypeStateIssuer
576749OtherVALUE OPTIONS
68204OtherVTBLUE CROSS BLUE SHIELD
1009231OtherVTFLETCHER ALLEN PREFERRED
2278542OtherVTCIGNA BEHAVIORAL HEALTH
1009231MedicaidVT
68204OtherVTVERMONT MANAGED CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20041208000743 VT Practitioner - Clinical Social Worker 3779549076 Reassigns benefits to 1 organization
Practice locations: Williston, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5399 Williston Rd
Suite 2
Williston, VT 05495-5320
Phone (802) 999-9237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0890000899VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of Burlington Inc CurrentSince May 22, 2012 Accepting new patients
Community Health Centers of Burlington Inc CurrentSince May 22, 2012 Accepting new patients

Locations

617 Riverside Ave
Burlington, VT 05401
Phone (802) 264-8158

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1497710560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BAYCREST DR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037713",
            "telephone_number": "802-999-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BAYCREST DR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037713",
            "telephone_number": "802-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYSKACEK",
        "first_name": "NAYA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "0890000899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "576749",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "68204",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLETCHER ALLEN PREFERRED",
            "identifier": "1009231",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2278542",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009231",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VERMONT MANAGED CARE",
            "identifier": "68204",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

Verify at the official NPI Registry.