Individual provider Active NPI

Sally Anne Fontana, LCSWR

  • Clinical Social Worker
  • Rome, NY
National Provider Identifier
1760708689
Registry record updated Apr 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO45353-1 Issued in NY
Practice address
227 W Dominick St
Rome, NY 13440-5853
Phone
(315) 336-6230
NPI assigned
Apr 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2010

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 RO45353-1 NY Primary

Addresses

Primary practice location

227 W Dominick St
Rome, NY 13440-5853

Mailing address

1607 Roser Ter
Rome, NY 13440-2313
Phone (315) 337-5553

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
I20250303001561 NY Order and Referring Only - Clinical Social Worker 3476823147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO45353-1NYMDClinical Social Worker
045353NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Cerebral Palsy, Inc Past 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, 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": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271376000000",
    "number": "1760708689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 ROSER TER",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402313",
            "telephone_number": "315-337-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 W DOMINICK ST",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134405853",
            "telephone_number": "315-336-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANA",
        "first_name": "SALLY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSWR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-16",
        "last_updated": "2010-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO45353-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, NY

Sources for this page

Verify at the official NPI Registry.