Individual provider Active NPI

Rose Beatrice Bishop, LCSW R

  • Clinical Social Worker
  • Syosset, NY
National Provider Identifier
1619040110
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO53518 Issued in NY
Practice address
175 Jericho TPK
Suite 218
Syosset, NY 11791
Phone
(516) 364-6920
Fax
(516) 496-8266
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X RO53518 NY Primary

Addresses

Primary practice location

175 Jericho TPK
Suite 218
Syosset, NY 11791

Mailing address

11 Meadow Lane
Syosset, NY 11791
Phone (516) 364-6920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO53518NYMDClinical Social Worker
053518NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Youth Environmental Services, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619040110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MEADOW LANE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "11791",
            "telephone_number": "516-364-6920",
            "fax_number": "516-496-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 JERICHO TPK",
            "address_2": "SUITE 218",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "11791",
            "telephone_number": "516-364-6920",
            "fax_number": "516-496-8266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "ROSE",
        "middle_name": "BEATRICE",
        "name_prefix": "Ms.",
        "credential": "LCSW R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO53518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.