Individual provider Active NPI

Nicole Dantuono

  • Clinical Social Worker
  • Williston Park, NY
National Provider Identifier
1720587249
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082820-1 Issued in NY
Practice address
129 Hillside Ave
Williston Park, NY 11596
Phone
(631) 764-2235
Fax
(646) 784-5534
NPI assigned
Feb 10, 2018
Last updated
Jun 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 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 082820-1 NY Primary

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

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
I20221011002165 NY Practitioner - Clinical Social Worker 0648646950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 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 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082820-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jun 21, 2022 Accepting new patients
North Shore - Lij Medical PC CurrentSince 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 H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1720587249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 HILLSIDE AVE",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "115962305",
            "telephone_number": "631-764-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 HILLSIDE AVE",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "11596",
            "telephone_number": "631-764-2235",
            "fax_number": "646-784-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTUONO",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-10",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082820-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston Park, NY

Sources for this page

Verify at the official NPI Registry.