Individual provider Active NPI

Lisa Braverman, LCSW

  • Clinical Social Worker
  • Oceanside, NY
National Provider Identifier
1497904429
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
080275 Issued in NY
Practice address
3227 Long Beach Rd Ste 2
Oceanside, NY 11572-3651
Phone
(516) 678-0900
NPI assigned
Sep 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0777391 NY
Clinical Social Worker 1041C0700X 080275 NY Primary

Addresses

Primary practice location

3227 Long Beach Rd Ste 2
Oceanside, NY 11572-3651

Mailing address

82-68 164TH Street
QHC-Pavilian
Jamaica, NY 11432-1447
Phone (718) 883-2964

Other names 1

  • Lisa Bobrow Former name

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
I20200306001986 NY Practitioner - Clinical Social Worker 9234567157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samuel Field YmandywhaGroup PAC ID 9537154638, 18 clinicians

Practice addresses (Care Compare)

5928 Little Neck Pkwy
Little Neck, NY 11362-2532
Phone (718) 224-0566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0777391NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel Field Ym&Ywha CurrentSince Oct 11, 2022 Accepting new patients
Karat Health, Inc. Past Accepting new patients
United Cerebral Palsy Assoc of Nys Inc. Past Accepting new patients

Locations

5928 Little Neck Pkwy
Little Neck, NY 11362
Phone (347) 306-0767

5820 Little Neck Pkwy
Little Neck, NY 11362
Phone 64651875842001

Organizations & group practices 3

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": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1497904429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82-68 164TH STREET",
            "address_2": "QHC-PAVILIAN",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321447",
            "telephone_number": "718-883-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3227 LONG BEACH RD STE 2",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115723651",
            "telephone_number": "516-678-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVERMAN",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0777391",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BOBROW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.