Individual provider Active NPI

Gail Harris

  • Clinical Social Worker
  • Far Rockaway, NY
National Provider Identifier
1720856511
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
092104-01 Issued in NY
Practice address
1600 Central Ave FL 2
Far Rockaway, NY 11691-4008
Phone
(718) 868-1400
Fax
(718) 327-5615
NPI assigned
Dec 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinical Social Worker 1041C0700X 092104-01 NY Primary

Addresses

Primary practice location

1600 Central Ave FL 2
Far Rockaway, NY 11691-4008

Mailing address

25314 85TH Rd
Bellerose, NY 11426-2126
Phone (917) 837-5308

Other names 1

  • Gail S Harris Other name

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
I20240305000709 NY Practitioner - Clinical Social Worker 7911342514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
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)

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

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

7559 263Rd St
RM 132
Glen Oaks, NY 11004-1150
Phone (718) 470-8023

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
092104NYMDClinical Social Worker
092104-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Feb 1, 2024 Accepting new patients
North Shore - Lij Medical PC CurrentSince Feb 1, 2024 Accepting new patients

Locations

1600 Central Ave
Fl 2
Far Rockaway, NY 11691
Phone (718) 327-5615

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

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

Networks

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

Interoperability endpoints

  • Direct secure messaging: gharrismulvena50508@northwell.direct-ci.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1720856511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25314 85TH RD",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114262126",
            "telephone_number": "917-837-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CENTRAL AVE FL 2",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914008",
            "telephone_number": "718-868-1400",
            "fax_number": "718-327-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "GAIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-12",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092104-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAIL",
            "last_name": "HARRIS",
            "middle_name": "S",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.