Individual provider Active NPI

Brianna Roose, LCSW

  • Social Worker
  • Cheektowaga, NY
National Provider Identifier
1760019012
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
104741-1 Issued in NY
Practice address
1526 Walden Ave Ste 400
Cheektowaga, NY 14225-4985
Phone
(716) 895-6700
NPI assigned
Mar 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 104741-1 NY Primary

Addresses

Primary practice location

1526 Walden Ave Ste 400
Cheektowaga, NY 14225-4985

Mailing address

1526 Walden Ave Ste 400
Cheektowaga, NY 14225-4985
Phone (716) 895-6700

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
I20231120001978 NY Practitioner - Clinical Social Worker 0345698924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Buffalo School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Professional Medical Concierge Services PLLCGroup PAC ID 0840614020, 75 clinicians

Practice addresses (Care Compare)

1785 Route 9
Halfmoon, NY 12065-2449
Phone (518) 238-6028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104741-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Medical Concierge Services, PLLC CurrentSince Nov 27, 2023 Accepting new patients
Mid Erie Mental Health Services Inc Social Worker CurrentSince Mar 29, 2020 Accepting new patients

Locations

1526 Walden Ave
Ste 400
Cheektowaga, NY 14225
Phone (716) 895-7167

1785 Route 9
Halfmoon, NY 12065
Phone (518) 238-6028

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1760019012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 WALDEN AVE STE 400",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254985",
            "telephone_number": "716-895-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 WALDEN AVE STE 400",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254985",
            "telephone_number": "716-895-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOSE",
        "first_name": "BRIANNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "104741-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

Verify at the official NPI Registry.