Individual provider Active NPI

David Lesser

  • Clinical Social Worker
  • Woodbury, NY
National Provider Identifier
1700324449
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089814 Issued in NY
Practice address
7600 Jericho Tpke
Woodbury, NY 11797-1728
Phone
(845) 641-9924
NPI assigned
Feb 2, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 0889492 NY
Clinical Social Worker 1041C0700X 089814 NY Primary

Addresses

Primary practice location

7600 Jericho Tpke
Woodbury, NY 11797-1728

Mailing address

49 Quebec Dr
Huntington Station, NY 11746-3872
Phone (845) 641-9924

Other practice location 1

49 Quebec Dr
Huntington Station, NY 11746-3872
Phone (845) 641-9924

Other identifiers 1

IdentifierTypeStateIssuer
85-0865119MedicaidNY

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
I20190905002027 NY Practitioner - Clinical Social Worker 8325377039 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0889492NYMDClinical Social Worker
089814NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Consultation Center Single Specialty CurrentSince Aug 15, 2021 Accepting new patients
Long Island Consultation Center, Inc. Clinical CurrentSince Jul 13, 2019 Accepting new patients

Locations

9131 Queens Blvd
Ste 222
Elmhurst, NY 11373
Phone (718) 896-3400

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

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": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1700324449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 QUEBEC DR",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117463872",
            "telephone_number": "845-641-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 JERICHO TPKE",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971728",
            "telephone_number": "845-641-9924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "49 Quebec Dr",
            "address_purpose": "LOCATION",
            "city": "Huntington Station",
            "state": "NY",
            "postal_code": "117463872",
            "country_code": "US",
            "telephone_number": "845-641-9924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LESSER",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-02",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0889492",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85-0865119",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NY

Sources for this page

Verify at the official NPI Registry.