Jacklyn Bystritsky

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

084563 Issued in NY

Practice address

57 Saint Marks PL
New York, NY 10003-7902

Phone

(212) 982-3470

NPI assigned

Jul 29, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Amy D Wicker Psy D PLLC

  • Counseling Psychologist
  • Brooklyn, NY
  • NPI 1255702221
  Medicare reassignment
• Mind Rejuvenation Therapy

  • Clinical Social Worker
  • New York, NY
  • NPI 1295299170
  NPD

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1659659381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 BAITING PLACE RD STE B",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117356233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 SAINT MARKS PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100037902",
            "telephone_number": "212-982-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYSTRITSKY",
        "first_name": "JACKLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "083806-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06239600",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW124471",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Byron Chiropractic PLLC
• Ryan Howard Byron-Fields, PA
• Danielle Colette Byron
• Lindsay S Byron, LCSW
• Marc D Bystock, L.AC.
• Chanmi Byun, PHD
• Hesoo Byun, PT, DPT
• Irene Byun, OD
• Sarah Byun, MD
• Jennifer Marcia Byxbee, ATR-BC, LCAT

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.