Keri Mica-Suttmiller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

071316 Issued in NY

Practice address

176 N Village Ave
Suite 2E
Rockville Centre, NY 11570-3800

Phone

(516) 410-7138

NPI assigned

Jun 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Keri Mica LCSW PC

  • Clinical Social Worker
  • Rockville Centre, NY
  • NPI 1053502518
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689617490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HART ST",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115631760",
            "telephone_number": "516-410-7138",
            "fax_number": "516-679-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 N VILLAGE AVE",
            "address_2": "SUITE 2E",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703800",
            "telephone_number": "516-410-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICA-SUTTMILLER",
        "first_name": "KERI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercy Medical Services PC
• Jessica Merino
• Metro Med Ny LLC
• Charity Meyer
• Kelly J Meyer, LMSW
• Michael D Sable, M.D. P.C.
• Michael J Rechter, DDS PC
• Michael S. Block, M.D. P.C.
• Michael Santo DPT PC
• Jonathan Michael, D.C.

• Clinical Social Worker in Rockville Centre, NY
• Providers in Rockville Centre, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.