Individual provider Active NPI

Christine M Tompkins, LCSW

  • Clinical Social Worker
  • Waterloo, NY
National Provider Identifier
1720197312
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076569 Issued in NY
Practice address
31 Thurber Dr
Waterloo, NY 13165-1600
Phone
(315) 539-1980
Fax
(315) 539-1054
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2009

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 076569 NY Primary

Addresses

Primary practice location

31 Thurber Dr
Waterloo, NY 13165-1600

Mailing address

31 Thurber Dr
Waterloo, NY 13165-1600
Phone (315) 539-1980

Other identifiers 1

IdentifierTypeStateIssuer
J400002073OtherNYMEDICARE

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
I20090225000428 NY Practitioner - Clinical Social Worker 7911063037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seneca County TreasurerGroup PAC ID 7416840301, 16 clinicians

Practice addresses (Care Compare)

31 Thurber Dr
Waterloo, NY 13165-1665
Phone (315) 539-1980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
076569NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Seneca County Addictions Program CurrentSince Feb 9, 2009 Accepting new patients
Seneca County Treasurer CurrentSince Feb 9, 2009 Accepting new patients

Locations

31 Thurber Dr
Waterloo, NY 13165
Phone (315) 539-1980

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1720197312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 THURBER DR",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "131651600",
            "telephone_number": "315-539-1980",
            "fax_number": "315-539-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 THURBER DR",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "131651600",
            "telephone_number": "315-539-1980",
            "fax_number": "315-539-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMPKINS",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "J400002073",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, NY

Sources for this page

Verify at the official NPI Registry.