Active NPI
Kristen Belevich
- Social Worker
- Bayside, NY
National Provider Identifier
1679931133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 092701
- Practice address
- 21111 Northern Blvd
Bayside, NY 11361-3241 - Phone
- (718) 705-1000
- NPI assigned
- Jan 29, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 092701 | NY | Primary |
Addresses
Primary practice location
21111 Northern Blvd
Bayside, NY 11361-3241
Mailing address
17 Harvard St
Massapequa, NY 11758-6131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 26, 2024 through Mar 26, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 089671 | NY | MD | Clinical Social Worker |
| 092701 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637625600000",
"number": "1679931133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 HARVARD ST",
"city": "MASSAPEQUA",
"state": "NY",
"postal_code": "117586131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21111 NORTHERN BLVD",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613241",
"telephone_number": "718-705-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELEVICH",
"first_name": "KRISTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-29",
"last_updated": "2021-11-23",
"certification_date": "2021-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "092701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.