Individual provider Active NPI

Debra Ilberman, LCSW

  • Clinical Social Worker
  • Roslyn, NY
National Provider Identifier
1558398131
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R033097 Issued in NY
Practice address
26 Sugar Maple Dr
Roslyn, NY 11576-3207
Phone
(516) 637-2703
NPI assigned
Jun 27, 2006
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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 R033097 NY Primary
Clinical Social Worker 1041C0700X R003097 NY

Addresses

Primary practice location

26 Sugar Maple Dr
Roslyn, NY 11576-3207

Mailing address

26 Sugar Maple Dr
Roslyn, NY 11576-3207
Phone (516) 637-2703

Other identifiers 1

IdentifierTypeStateIssuer
01382663MedicaidNY

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
I20060410000101 NY Practitioner - Clinical Social Worker 1850300526 Reassigns benefits to 1 organization
Practice locations: Manhasset, NY; Roslyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mashadi Bikkur Cholim IncGroup PAC ID 0840724928, 2 clinicians

Practice addresses (Care Compare)

333 E Shore Rd
Suite 206
Manhasset, NY 11030-2900
Phone (516) 387-2228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R003097NYMDClinical Social Worker
R033097NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mashadi Bikkur Cholim, Inc CurrentSince Oct 1, 2024 Accepting new patients
Karat Health, Inc. PastSince Aug 1, 1994 Accepting new patients
United Cerebral Palsy Assoc of Nys Inc. Past Accepting new patients

Locations

333 E Shore Rd
Ste 206
Manhasset, NY 11030
Phone (516) 387-2228

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, 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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1558398131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SUGAR MAPLE DR",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115763207",
            "telephone_number": "516-637-2703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 SUGAR MAPLE DR",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115763207",
            "telephone_number": "516-637-2703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILBERMAN",
        "first_name": "DEBRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R033097",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R003097",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01382663",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

Verify at the official NPI Registry.