Active NPI
William C. Devery, L.C.S.W.
- Clinical Social Worker
- Staten Island, NY
National Provider Identifier
1770681900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R027896-1
- Practice address
- 1345 N Railroad Ave
Staten Island, NY 10306-2348 - Phone
- (718) 351-0555
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R027896-1 | NY | Primary |
| Clinical Social Worker | 1041C0700X | SC 07460 | NJ |
Addresses
Primary practice location
1345 N Railroad Ave
Staten Island, NY 10306-2348
Mailing address
22 Cornell Dr
East Brunswick, NJ 08816-5318
Phone (732) 698-0280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0019274 | Other | NY | GHI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150401000961 | NY | Practitioner - Clinical Social Worker | 6901123983 | Practice locations: Staten Island, NY |
| I20210225002196 | NJ | Practitioner - Clinical Social Worker | 6901123983 | Practice locations: Helmetta, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
17 George W Helme Dr
Helmetta, NJ 08828-1172
Phone (718) 351-0555
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC 07460 | NJ | MD | Clinical Social Worker |
| R027896-1 | NY | MD | Clinical Social Worker |
| 027896 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405900800000",
"number": "1770681900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 CORNELL DR",
"city": "EAST BRUNSWICK",
"state": "NJ",
"postal_code": "088165318",
"telephone_number": "732-698-0280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1345 N RAILROAD AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103062348",
"telephone_number": "718-351-0555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVERY",
"first_name": "WILLIAM",
"middle_name": "C.",
"name_prefix": "Mr.",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2014-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R027896-1",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "SC 07460",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0019274",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.