Individual provider Active NPI

Maryann Desilva

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1720316474
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071347 Issued in NY
Practice address
1694 E 53Rd St
Brooklyn, NY 11234-3917
Phone
(718) 253-4105
NPI assigned
Nov 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 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 071347 NY Primary

Addresses

Primary practice location

1694 E 53Rd St
Brooklyn, NY 11234-3917

Mailing address

1694 E 53Rd St
Brooklyn, NY 11234-3917
Phone (718) 253-4105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • 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
I20170714001187 NY Practitioner - Clinical Social Worker 0042580698 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince May 15, 2017 Accepting new patients
North Shore-Lij Medical PC CurrentSince May 15, 2017 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

27005 76th Ave
#222
New Hyde Park, NY 11040
Phone (718) 470-7260

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

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": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258502400000",
    "number": "1720316474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1694 E 53RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112343917",
            "telephone_number": "718-253-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1694 E 53RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112343917",
            "telephone_number": "718-253-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESILVA",
        "first_name": "MARYANN",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-18",
        "last_updated": "2009-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.