Individual provider Active NPI

James Sebastian Spano, LCSW-R

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1578669495
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R.035856-1 Issued in NY
Practice address
208 Twin Hills Drive
Syracuse, NY 13207
Phone
(315) 247-6219
Fax
(315) 428-0292
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

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 R0358561 NY
Clinical Social Worker 1041C0700X R.035856-1 NY Primary

Addresses

Primary practice location

208 Twin Hills Drive
Syracuse, NY 13207

Mailing address

208 Twin Hills Drive
Syracuse, NY 13207
Phone (315) 247-6219

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
I20050215000740 NY Practitioner - Clinical Social Worker 0345292652 Practice locations: Syracuse, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

208 Twin Hills Dr
Syracuse, NY 13207-1515
Phone (315) 247-6219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R.035856-1NYMDClinical Social Worker
R0358561NYMDClinical Social Worker
035856NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1578669495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 TWIN HILLS DRIVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13207",
            "telephone_number": "315-247-6219",
            "fax_number": "315-428-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 TWIN HILLS DRIVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13207",
            "telephone_number": "315-247-6219",
            "fax_number": "315-428-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANO",
        "first_name": "JAMES",
        "middle_name": "SEBASTIAN",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0358561",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R.035856-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.