Individual provider Active NPI

Barbara Komsic, LMSW

  • Clinical Social Worker
  • Ellenville, NY
National Provider Identifier
1669649489
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
084714 Issued in NY
Practice address
6 Healthy Way
Ellenville, NY 12428-5612
Phone
(845) 647-4500
Fax
(845) 647-7632
NPI assigned
May 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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 084714 NY Primary

Addresses

Primary practice location

6 Healthy Way
Ellenville, NY 12428-5612

Mailing address

6 Healthy Way
Ellenville, NY 12428-5612
Phone (845) 647-4500

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
I20190123001705 NY Practitioner - Clinical Social Worker 7719265339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Institute for Family HealthGroup PAC ID 9234048588, 188 clinicians

Practice addresses (Care Compare)

6 Healthy Way
Ellenville, NY 12428-5612
Phone (845) 647-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
084714NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Institute for Family Health Clinical CurrentSince Dec 8, 2018 Accepting new patients
The Institute for Family Health Clinical CurrentSince Dec 8, 2018 Accepting new patients
The Institute for Family Health Clinical Current Accepting new patients

Locations

6 Healthy Way
Ellenville, NY 12428
Phone (845) 647-4500

1 Family Practice Dr
Kingston, NY 12401
Phone (845) 338-2562

279 Main St
Ste 204
New Paltz, NY 12561
Phone (845) 255-3046

1824 Madison Ave
New York, NY 10035
Phone (212) 423-4200

16 E 16th St
New York, NY 10003
Phone (212) 633-0800

Organizations & group practices 3

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": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1669649489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HEALTHY WAY",
            "city": "ELLENVILLE",
            "state": "NY",
            "postal_code": "124285612",
            "telephone_number": "845-647-4500",
            "fax_number": "845-647-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 HEALTHY WAY",
            "city": "ELLENVILLE",
            "state": "NY",
            "postal_code": "124285612",
            "telephone_number": "845-647-4500",
            "fax_number": "845-647-7632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMSIC",
        "first_name": "BARBARA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenville, NY

Sources for this page

Verify at the official NPI Registry.