Individual provider Active NPI

Bianca Kattan, LCSW

  • Clinical Social Worker
  • Bayside, NY
National Provider Identifier
1639392038
Registry record updated Jul 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R049229-1 Issued in NY
Practice address
1835 Bell Blvd
Bayside, NY 11360-1641
Phone
(917) 579-5752
NPI assigned
Apr 11, 2007
Last updated
Jul 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2017

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 R049229-1 NY Primary

Addresses

Primary practice location

1835 Bell Blvd
Bayside, NY 11360-1641

Mailing address

42 Acorn Ponds Dr
Roslyn, NY 11576-2818
Phone (917) 579-5752

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
I20170706000343 NY Practitioner - Clinical Social Worker 1254563554 Practice locations: Manhasset, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

86 Webster Ave
Manhasset, NY 11030-1922
Phone (917) 579-5752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R049229-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Consultation Center, Inc. Clinical PastSince Sep 2, 2003 Accepting new patients
Long Island Consultation Center PastSince Aug 15, 2021 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499212800000",
    "number": "1639392038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 ACORN PONDS DR",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115762818",
            "telephone_number": "917-579-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601641",
            "telephone_number": "917-579-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATTAN",
        "first_name": "BIANCA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2017-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R049229-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.