Individual provider Active NPI

Denisse Lisex Antonio

  • Clinical Social Worker
  • Jamaica, NY
National Provider Identifier
1548024185
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
096281 Issued in NY
Practice address
8319 141St St Apt 709
Jamaica, NY 11435-1622
Phone
(516) 343-4385
NPI assigned
Feb 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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 096281 NY Primary

Addresses

Primary practice location

8319 141St St Apt 709
Jamaica, NY 11435-1622

Mailing address

8319 141St St Apt 709
Jamaica, NY 11435-1622
Phone (516) 343-4385

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
I20251126002895 NY Practitioner - Clinical Social Worker 2961994801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
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)

75 -59
Glen Oaks, NY 11004-1150
Phone (718) 470-8100

Hospital & facility affiliations

  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
096281NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Oct 1, 2025 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

7559 263rd St
Glen Oaks, NY 11004
Phone (718) 470-8005

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1548024185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8319 141ST ST APT 709",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114351622",
            "telephone_number": "516-343-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8319 141ST ST APT 709",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114351622",
            "telephone_number": "516-343-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIO",
        "first_name": "DENISSE",
        "middle_name": "LISEX",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.