Individual provider Active NPI

Joseph Bush

  • Clinical Social Worker
  • Garden City, NY
National Provider Identifier
1619449634
Registry record updated May 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09336 Issued in NY
Practice address
400 Oak St Ste 104
Garden City, NY 11530-6554
Phone
(516) 485-5975
NPI assigned
Jan 2, 2019
Last updated
May 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 104573 NY
Clinical Social Worker 1041C0700X 09336 NY Primary

Addresses

Primary practice location

400 Oak St Ste 104
Garden City, NY 11530-6554

Mailing address

496 Smithtown Byp Ste 203
Smithtown, NY 11787-5011
Phone (631) 371-3825

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
I20220810000466 NY Practitioner - Clinical Social Worker 1557744455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Rachel Lessard LCSW PCGroup PAC ID 9032517107, 9 clinicians

Practice addresses (Care Compare)

496 Smithtown Byp
Suite 203
Smithtown, NY 11787-5011
Phone (516) 404-7337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104573NYMDCounselor
09336NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Within Wisdom and Wellness Collaborative LLC Clinical Current Accepting new patients
Rachel Lessard LCSW PC Clinical CurrentSince Jun 1, 2022 Accepting new patients

Locations

520 Franklin Ave
Ste L1
Garden City, NY 11530
Phone (516) 515-0696

496 Smithtown Byp
Smithtown, NY 11787
Phone (631) 360-8000

496 Smithtown Byp
Ste 203
Smithtown, NY 11787
Phone (516) 404-7337

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651363200000",
    "number": "1619449634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP STE 203",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875011",
            "telephone_number": "631-371-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 OAK ST STE 104",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115306554",
            "telephone_number": "516-485-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-02",
        "last_updated": "2022-05-01",
        "certification_date": "2022-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "104573",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "09336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.