Individual provider Active NPI

Kylee Ann Lindberg, LCSW

  • Clinical Social Worker
  • Albany, NY
National Provider Identifier
1669808085
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
084333-01 Issued in NY
Practice address
391 Western Ave
Albany, NY 12203-1401
Phone
(518) 242-4731
Fax
(518) 242-4747
NPI assigned
Sep 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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 084333-01 NY Primary

Addresses

Primary practice location

391 Western Ave
Albany, NY 12203-1401

Mailing address

391 Western Ave
Albany, NY 12203-1401
Phone (518) 242-4731

Other names 1

  • Ms. Kylee Ann Thomson Former name

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
I20210813002017 NY Practitioner - Clinical Social Worker 3678977501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Boston University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Medical Concierge Services PLLCGroup PAC ID 0840614020, 75 clinicians

Practice addresses (Care Compare)

1785 Route 9
Halfmoon, NY 12065-2449
Phone (518) 238-6028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
084333-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Medical Concierge Services, PLLC Clinical CurrentSince Aug 3, 2021 Accepting new patients

Locations

1785 Route 9
Halfmoon, NY 12065
Phone (518) 238-6028

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.

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1669808085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 WESTERN AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122031401",
            "telephone_number": "518-242-4731",
            "fax_number": "518-242-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 WESTERN AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122031401",
            "telephone_number": "518-242-4731",
            "fax_number": "518-242-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDBERG",
        "first_name": "KYLEE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084333-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLEE",
            "last_name": "THOMSON",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.