Individual provider Active NPI

Elisa M Rappoport

  • Clinical Social Worker
  • Great Neck, NY
National Provider Identifier
1639290802
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PO63334-1 Issued in NY
Practice address
29 Barstow Rd Ste 302
Great Neck, NY 11021-2209
Phone
(516) 458-1705
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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 PO63334-1 NY Primary

Addresses

Primary practice location

29 Barstow Rd Ste 302
Great Neck, NY 11021-2209

Mailing address

29 Barstow Rd Ste 302
Great Neck, NY 11021-2209
Phone (516) 458-1705

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
I20050802001137 NY Practitioner - Clinical Social Worker 6002844800 Practice locations: Douglaston, NY; Great Neck, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

90 Schenck Ave
Apt 1a
Great Neck, NY 11021-3626
Phone (516) 458-1705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO63334-1NYMDClinical Social Worker
063334NYMDDentist

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254268800000",
    "number": "1639290802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 BARSTOW RD STE 302",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212209",
            "telephone_number": "516-458-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 BARSTOW RD STE 302",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212209",
            "telephone_number": "516-458-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPPOPORT",
        "first_name": "ELISA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2009-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PO63334-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.