Individual provider Active NPI

Michael Salvatore Mennella

  • Social Worker
  • Mastic, NY
National Provider Identifier
1689549784
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1235 Montauk Hwy
Mastic, NY 11950-2917
Phone
(631) 345-0083
NPI assigned
Oct 8, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

1235 Montauk Hwy
Mastic, NY 11950-2917

Mailing address

220 Gibbs Pond Rd
Nesconset, NY 11767-2256
Phone (631) 335-0760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1759881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1689549784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 GIBBS POND RD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117672256",
            "telephone_number": "631-335-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 MONTAUK HWY",
            "city": "MASTIC",
            "state": "NY",
            "postal_code": "119502917",
            "telephone_number": "631-345-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENNELLA",
        "first_name": "MICHAEL",
        "middle_name": "SALVATORE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-08",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mastic, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.