Nicole Gabrielle Balzafiore

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

091163 Issued in NY

Practice address

159 Carleton Ave
Central Islip, NY 11722-4172

Phone

(631) 650-2510

NPI assigned

Apr 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCJFAD

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.

• Long Island Select Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Central Islip, NY
  • NPI 1043663107

  NY

  Medicare reassignment NPD
• Long Island Select Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hauppauge, NY
  • NPI 1700331691
  NPD

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1568040319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD STE G02",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 CARLETON AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117224172",
            "telephone_number": "631-650-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALZAFIORE",
        "first_name": "NICOLE",
        "middle_name": "GABRIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Isabel Aviles
• Folake Motunrayo Awolowo
• Muili Adebayo Awotorebo, LPN
• Barbara Azcona, R.N.
• Mary Baldassi, COTA
• Lucretia Cory Banks, LPN
• Nicole Barrett
• Tania Patricia Barrezueta, LCSW
• Mona Bascetta, PA
• Jessy Beaubrun

• All providers in Central Islip, NY
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.