Individual provider Active NPI

Penny E Siegmann-Beiner, LCSW-R

  • Clinical Social Worker
  • Massapequa, NY
National Provider Identifier
1730175738
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R053589-1 Issued in NY
Practice address
54 Chicago Ave
Massapequa, NY 11758
Phone
(516) 528-6712
NPI assigned
Sep 25, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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 R053589-1 NY Primary

Addresses

Primary practice location

54 Chicago Ave
Massapequa, NY 11758

Mailing address

54 Chicago Ave
Massapequa, NY 11758

Other identifiers 1

IdentifierTypeStateIssuer
01703777MedicaidNY

Other names 1

  • Penny E Siegmann Former 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
I20101015000739 NY Practitioner - Clinical Social Worker 3173716750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Stony Brook, School of Medicine, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

54 Chicago Ave
Massapequa, NY 11758-4422
Phone (516) 998-8350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R053589-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Services of Long Island LCSW PC CurrentSince Jan 1, 2018 Accepting new patients

Organizations & group practices 1

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": "1127606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1730175738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 CHICAGO AVE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 CHICAGO AVE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758",
            "telephone_number": "516-528-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGMANN-BEINER",
        "first_name": "PENNY",
        "middle_name": "E",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-25",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R053589-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01703777",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNY",
            "last_name": "SIEGMANN",
            "middle_name": "E",
            "credential": "LCSW-R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.