Individual provider Active NPI

Ann P Smollon, LCSW-R

  • Clinical Social Worker
  • Garden City Park, NY
National Provider Identifier
1689769887
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R 039137 Issued in NY
Practice address
44 Dyckman Avenue
Garden City Park, NY 11040
Phone
(516) 398-8695
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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 R 039137 NY Primary

Addresses

Primary practice location

44 Dyckman Avenue
Garden City Park, NY 11040

Mailing address

PO Box 7509
Garden City, NY 11530-0790
Phone (516) 398-8695

Other names 1

  • Ann P Piazza 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
I20050829001026 NY Practitioner - Clinical Social Worker 1951332980 Practice locations: Garden City Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

44 Dyckman Ave
Garden City Park, NY 11040-5049
Phone (516) 398-8695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R 039137NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Juliana Kanji Psychiatric Services, PC Past Accepting new patients

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1689769887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7509",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115300790",
            "telephone_number": "516-398-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 DYCKMAN AVENUE",
            "city": "GARDEN CITY PARK",
            "state": "NY",
            "postal_code": "11040",
            "telephone_number": "516-398-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLLON",
        "first_name": "ANN",
        "middle_name": "P",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R 039137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "PIAZZA",
            "middle_name": "P",
            "credential": "LCSW-R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Garden City Park, NY

Sources for this page

Verify at the official NPI Registry.