Tracy Elizabeth Phillips, LCSW, ATR

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R055230-1 Issued in NY

Practice address

2795 Richmond Ave
Staten Island, NY 10314-5857

Phone

(718) 761-9800

NPI assigned

Oct 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Clinical Social Worker

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578648309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 GREENWOOD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181311",
            "telephone_number": "718-854-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145857",
            "telephone_number": "718-761-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TRACY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LCSW, ATR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R055230-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00055230",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLEN",
            "identifier": "W22701",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH FIRST",
            "identifier": "055230A37",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liam Jamal Phillip, LPN
• Madeline Phillipps, LCSW
• Martin Phillipps
• Joanne Madeline Phillips, NP
• Laura J Phillips, R.N.
• Eileen Susan Phoenix, L.AC.
• Chaw Ngon Phoo, MD
• Physical Medicine and Rehabilitation Associates of Staten Island LLP
• Physical Therapy Link PC
• Physical Therapy Link PC

• Clinical Social Worker in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.