Individual provider Active NPI

John Shear Jr., LCSW

  • Clinical Social Worker
  • Buffalo, NY
National Provider Identifier
1699093195
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079875-1 Issued in NY
Practice address
467 Virginia St
Buffalo, NY 14202-1318
Phone
(716) 855-0880
Fax
(716) 855-0880
NPI assigned
May 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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 079875-1 NY Primary

Addresses

Primary practice location

467 Virginia St
Buffalo, NY 14202-1318

Mailing address

467 Virginia St
Buffalo, NY 14202-1318
Phone (716) 855-0880

Other names 1

  • Mr. John Shear Other 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
I20131209000754 NY Practitioner - Clinical Social Worker 7012144553 Practice locations: Tonawanda, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Buffalo School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

884 Brighton Rd
Tonawanda, NY 14150-8169
Phone (716) 836-9460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
079875-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1273190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1699093195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 VIRGINIA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021318",
            "telephone_number": "716-855-0880",
            "fax_number": "716-855-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 VIRGINIA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021318",
            "telephone_number": "716-855-0880",
            "fax_number": "716-855-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEAR",
        "first_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-07",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079875-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "SHEAR",
            "prefix": "MR.",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.