Individual provider Active NPI

Christian Nicholas Caputo, LCSW

  • Clinical Social Worker
  • Riverhead, NY
National Provider Identifier
1669425914
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RP003027-1 Issued in NY
Practice address
619 Roanoke Ave
Riverhead, NY 11901-2727
Phone
(631) 369-1718
Fax
(631) 874-8618
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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 RP003027-1 NY Primary

Addresses

Primary practice location

619 Roanoke Ave
Riverhead, NY 11901-2727

Mailing address

166 Hampton Vista Dr
Manorville, NY 11949-2861
Phone (631) 369-1718

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
I20031218000280 NY Practitioner - Clinical Social Worker 0143127506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

36 E 2ND St
Suite 202
Riverhead, NY 11901-4731
Phone (631) 374-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RP003027-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Christian N. Caputo, LCSW, P.C. Clinical CurrentSince Jun 6, 2001 Accepting new patients
Island Psychiatry, P.C. Past Accepting new patients

Locations

903 Main St
Port Jefferson, NY 11777
Phone (631) 374-9400

420 E Main St
Riverhead, NY 11901
Phone (631) 369-1718

619 Roanoke Ave
Riverhead, NY 11901
Phone (631) 208-9219

36 E 2nd St
Ste 202
Riverhead, NY 11901
Phone (631) 208-9219

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1669425914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 HAMPTON VISTA DR",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492861",
            "telephone_number": "631-369-1718",
            "fax_number": "631-874-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012727",
            "telephone_number": "631-369-1718",
            "fax_number": "631-874-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPUTO",
        "first_name": "CHRISTIAN",
        "middle_name": "NICHOLAS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RP003027-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.