Vincent Louis Desimone, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

069315 Issued in NY

Practice address

363 Route 111
Smithtown, NY 11787-4756

Phone

(631) 680-7866

Fax

(631) 261-7095

NPI assigned

Dec 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598825200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WATERVIEW DR",
            "city": "CENTERPORT",
            "state": "NY",
            "postal_code": "117211636",
            "telephone_number": "631-680-7866",
            "fax_number": "631-261-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 ROUTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874756",
            "telephone_number": "631-680-7866",
            "fax_number": "631-261-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESIMONE",
        "first_name": "VINCENT",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02470097",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Smithtown, NY
• Providers in Smithtown, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.