Individual provider Active NPI

Andrea Wang-Castaneda, LCSW

  • Clinical Social Worker
  • Port Chester, NY
National Provider Identifier
1639762065
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
094288-01 Issued in NY
Practice address
5 Grace Church St
Port Chester, NY 10573-4911
Phone
(914) 937-8899
NPI assigned
Feb 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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 094288-01 NY Primary

Addresses

Primary practice location

5 Grace Church St
Port Chester, NY 10573-4911

Mailing address

16 Brook Rd
Port Chester, NY 10573-3147
Phone (914) 648-0426

Other identifiers 1

IdentifierTypeStateIssuer
103056MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230201002896 NY Practitioner - Clinical Social Worker 8921470816 Reassigns benefits to 2 organizations
I20260209000897 CT Practitioner - Clinical Social Worker 8921470816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Open Door Family Medical Center IncGroup PAC ID 7113835380, shared by 7 NPIs, 61 clinicians

Practice addresses (Care Compare)

5 Grace Church St
Port Chester, NY 10573-4911
Phone (914) 632-2737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
094288-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Family Medical Center, Inc. CurrentSince Jan 16, 2023 Accepting new patients
State of Connecticut CurrentSince Jan 9, 2026 Accepting new patients
Open Door Family Medical Center Inc Current Accepting new patients
Comprehensive Counseling LCSW, PLLC Clinical CurrentSince Nov 29, 2023 Accepting new patients
Open Door Family Medical Center Inc CurrentSince Jan 16, 2023 Accepting new patients
State of Connecticut CurrentSince Jan 9, 2026 Accepting new patients

Locations

1635 Central Ave
Bridgeport, CT 06610
Phone (203) 551-7464

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

2 Main St
Ste 2A
Plymouth, MA 02360

3635 Bell Blvd
Ste 203
Bayside, NY 11361
Phone (718) 504-9256

165 Main St
Ossining, NY 10562
Phone (914) 941-1263

5 Grace Church St
Port Chester, NY 10573
Phone (914) 937-8899

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EAJCAA

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1639762065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BROOK RD",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105733147",
            "telephone_number": "914-648-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GRACE CHURCH ST",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734911",
            "telephone_number": "914-937-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG-CASTANEDA",
        "first_name": "ANDREA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094288-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103056",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Chester, NY

Sources for this page

Verify at the official NPI Registry.