Individual provider Active NPI

Andrea D Hawkins, BA.,MSW

  • Case Manager/Care Coordinator
  • W Brentwood, NY
National Provider Identifier
1639241714
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
1160000464 Issued in NY
Practice address
998 Crooked Hill Rd
Building 69
W Brentwood, NY 11717-1043
Phone
(631) 761-4159
Fax
(631) 761-4184
NPI assigned
Nov 14, 2006
Last updated
Mar 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 1160000464 NY Primary

Addresses

Primary practice location

998 Crooked Hill Rd
Building 69
W Brentwood, NY 11717-1043

Mailing address

998 Crooked Hill Rd
Building 69
W Brentwood, NY 11717-1043
Phone (631) 761-4159

Other identifiers 1

IdentifierTypeStateIssuer
116000464MedicaidNY

Other names 1

  • Andrea D. Welcome Former name

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)
Not enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
1160000464NYMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1639241714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 CROOKED HILL RD",
            "address_2": "BUILDING 69",
            "city": "W BRENTWOOD",
            "state": "NY",
            "postal_code": "117171043",
            "telephone_number": "631-761-4159",
            "fax_number": "631-761-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 CROOKED HILL RD",
            "address_2": "BUILDING 69",
            "city": "W BRENTWOOD",
            "state": "NY",
            "postal_code": "117171043",
            "telephone_number": "631-761-4159",
            "fax_number": "631-761-4184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "ANDREA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "BA.,MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": "1160000464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116000464",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "WELCOME",
            "middle_name": "D.",
            "credential": "MSQ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in W Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; 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.