Active NPI
Leslie Kripa Samuel Verghese, LCSW-R
- Clinical Social Worker
- Bethpage, NY
National Provider Identifier
1639399389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R057933
- Practice address
- 14 Verly CT
Bethpage, NY 11714-5910 - Phone
- (516) 520-1230
- Fax
- (718) 454-3584
- NPI assigned
- Apr 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R057933 | NY | Primary |
Addresses
Primary practice location
14 Verly CT
Bethpage, NY 11714-5910
Mailing address
14 Verly CT
Bethpage, NY 11714-5910
Phone (516) 520-1230
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
| License | State | Type | Specialty |
|---|---|---|---|
| R057933 | NY | MD | Clinical Social Worker |
| 057933 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empress Ambulance Service LLC | 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.
-
- Ambulance
- Yonkers, NY
- NPI 1003878596
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639399389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 VERLY CT",
"city": "BETHPAGE",
"state": "NY",
"postal_code": "117145910",
"telephone_number": "516-520-1230",
"fax_number": "718-454-3584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 VERLY CT",
"city": "BETHPAGE",
"state": "NY",
"postal_code": "117145910",
"telephone_number": "516-520-1230",
"fax_number": "718-454-3584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERGHESE",
"first_name": "LESLIE",
"middle_name": "KRIPA SAMUEL",
"name_prefix": "Mr.",
"credential": "LCSW-R",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R057933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bethpage, 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.