Individual provider Active NPI

Jennifer Laura Rogak, LCSW R

  • Clinical Social Worker
  • Stony Brook, NY
National Provider Identifier
1699769570
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R052561-1 Issued in NY
Practice address
8 Westwood Ave
Stony Brook, NY 11790-2837
Phone
(516) 313-5556
Fax
(631) 751-5762
NPI assigned
Sep 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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 R052561-1 NY Primary

Addresses

Primary practice location

8 Westwood Ave
Stony Brook, NY 11790-2837

Mailing address

8 Westwood Ave
Stony Brook, NY 11790-2837
Phone (516) 313-5556

Other identifiers 1

IdentifierTypeStateIssuer
02561360MedicaidNY

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
I20040419000640 NY Practitioner - Clinical Social Worker 4587659537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Options Systems LCSW LLPGroup PAC ID 5092817841, 4 clinicians

Practice addresses (Care Compare)

8 Westwood Ave
Stony Brook, NY 11790-2837
Phone (516) 313-5556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R052561-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Options Systems LCSW LLP Clinical CurrentSince Aug 20, 2006 Accepting new patients
Senior Options Systems LLP Clinical PastSince Apr 21, 2004 Accepting new patients

Organizations & group practices 2

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1699769570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 WESTWOOD AVE",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902837",
            "telephone_number": "516-313-5556",
            "fax_number": "631-751-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 WESTWOOD AVE",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902837",
            "telephone_number": "516-313-5556",
            "fax_number": "631-751-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGAK",
        "first_name": "JENNIFER",
        "middle_name": "LAURA",
        "name_prefix": "Mrs.",
        "credential": "LCSW R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R052561-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02561360",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.