Individual provider Active NPI

Ian Stewart

  • Clinical Social Worker
  • Astoria, NY
National Provider Identifier
1750983748
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090598-01 Issued in NY
Practice address
3063 35TH St
Astoria, NY 11103-4701
Phone
(516) 644-7699
NPI assigned
Nov 13, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 102325-01 NY
Clinical Social Worker 1041C0700X 090598-01 NY Primary

Addresses

Primary practice location

3063 35TH St
Astoria, NY 11103-4701

Mailing address

3063 35TH St
Astoria, NY 11103-4701
Phone (516) 644-7699

Other practice location 1

210 E 64th St
New York, NY 10065-7471
Phone (516) 644-7699

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
I20210420001432 NY Practitioner - Clinical Social Worker 4082022652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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
090598-01NYMDClinical Social Worker
102325-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Dec 17, 2020 Accepting new patients
North Shore-Lij Medical PC CurrentSince Dec 17, 2020 Accepting new patients

Locations

210 E 64th St
New York, NY 10065
Phone (212) 434-4312

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": "1605225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1750983748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3063 35TH ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111034701",
            "telephone_number": "516-644-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3063 35TH ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111034701",
            "telephone_number": "516-644-7699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 E 64th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100657471",
            "country_code": "US",
            "telephone_number": "516-644-7699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "IAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "102325-01",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090598-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.