Nicole Dantuono

Individual provider Active NPI Clinical Social Worker · Williston Park, NY

NPI 1720587249 · NPPES record last updated Jun 8, 2018

Key facts

NPI
1720587249
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
082820-1 (NY)
Practice address
129 Hillside Ave
Williston Park, NY 11596
Phone
(631) 764-2235
Fax
(646) 784-5534
NPI assigned
Feb 10, 2018
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PC (6,374 clinicians)

Practice addresses (Care Compare)

75 -59
Glen Oaks, NY 11004-1150
Phone (718) 470-8100

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100 (apm)
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20221011002165 NY Practitioner - Clinical Social Worker 0648646950 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
082820-1NYMDClinical Social Worker

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Current
since Jun 21, 2022
Accepting new patients
North Shore - Lij Medical PC Current
since Jun 21, 2022
Accepting new patients

Locations

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

7559 263rd St
Glen Oaks, NY 11004
Phone (718) 470-8005

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 082820-1 NY Yes

Addresses

Primary practice location

129 Hillside Ave
Williston Park, NY 11596

Mailing address

129 Hillside Ave
Williston Park, NY 11596-2305
Phone (631) 764-2235

Other providers in Williston Park, NY

All providers in Williston Park, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.