Individual provider Active NPI

Wayne Gurnick, LCSW

  • Clinical Social Worker
  • Coram, NY
National Provider Identifier
1760621395
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
050891-1 Issued in NY
Practice address
3600 Route 112
Coram, NY 11727-4116
Phone
(631) 920-8302
NPI assigned
Feb 4, 2009
Last updated
Feb 4, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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 050891-1 NY Primary

Addresses

Primary practice location

3600 Route 112
Coram, NY 11727-4116

Mailing address

3600 Route 112
Coram, NY 11727-4116

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
I20170207001166 NY Practitioner - Clinical Social Worker 0345524930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

250 Montauk Hwy
East Moriches, NY 11940-1141
Phone (631) 603-7902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
050891-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne M. Gurnick Ms, LCSW P.C. Clinical CurrentSince Dec 5, 2016 Accepting new patients

Locations

250 Montauk Hwy
East Moriches, NY 11940
Phone (631) 603-7902

Networks

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

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, 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": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1760621395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 112",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117274116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 112",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117274116",
            "telephone_number": "631-920-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURNICK",
        "first_name": "WAYNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "050891-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coram, NY

Sources for this page

Verify at the official NPI Registry.