Individual provider Active NPI

Daniel Serpico, LCSW

  • Clinical Social Worker
  • Toms River, NJ
National Provider Identifier
1548640618
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05809100 Issued in NJ
Practice address
509 Main St
BLDG C
Toms River, NJ 08753-7402
Phone
(732) 773-8832
NPI assigned
Jun 4, 2015
Last updated
May 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 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 44SC05809100 NJ Primary

Addresses

Primary practice location

509 Main St
BLDG C
Toms River, NJ 08753-7402

Mailing address

18 Starboard St
Beachwood, NJ 08722-2958
Phone (732) 773-8832

Other practice location 1

509 Main St
BLDG C
Toms River, NJ 08753-7402
Phone (732) 773-8832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20181009000375 NJ Practitioner - Clinical Social Worker 0345592077 Practice locations: Toms River, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

509 Main St
BLDG C
Toms River, NJ 08753-7402
Phone (732) 773-8832

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05809100NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1548640618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 STARBOARD ST",
            "city": "BEACHWOOD",
            "state": "NJ",
            "postal_code": "087222958",
            "telephone_number": "732-773-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 MAIN ST",
            "address_2": "BLDG C",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087537402",
            "telephone_number": "732-773-8832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 MAIN ST",
            "address_2": "BLDG C",
            "address_purpose": "LOCATION",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087537402",
            "country_code": "US",
            "telephone_number": "732-773-8832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERPICO",
        "first_name": "DANIEL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05809100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

Verify at the official NPI Registry.