Active NPI
Robert Blaney, LCSW
- Social Worker
- Ozone Park, NY
National Provider Identifier
1578629895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 00053299
- Practice address
- 108-19 Rockaway Blvd
Ozone Park, NY 11420 - Phone
- (718) 845-2620
- Fax
- (718) 845-9380
- NPI assigned
- Dec 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 00053299 | NY | Primary |
Addresses
Primary practice location
108-19 Rockaway Blvd
Ozone Park, NY 11420
Mailing address
1 Tanager Lane
Levittown, NY 11756
Phone (718) 845-2620
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00053299 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081016000205 | NY | Practitioner - Clinical Social Worker | 9739247933 | Practice locations: Wantagh, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1400 Wantagh Ave
Suite 201
Wantagh, NY 11793-2210
Phone (917) 655-8528
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00053299 | NY | MD | Social Worker |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191542400000",
"number": "1578629895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 TANAGER LANE",
"city": "LEVITTOWN",
"state": "NY",
"postal_code": "11756",
"telephone_number": "718-845-2620",
"fax_number": "718-845-9380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108-19 ROCKAWAY BLVD",
"city": "OZONE PARK",
"state": "NY",
"postal_code": "11420",
"telephone_number": "718-845-2620",
"fax_number": "718-845-9380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANEY",
"first_name": "ROBERT",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-29",
"last_updated": "2007-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "00053299",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00053299",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ozone Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.