Active NPI
Nabeel Saad
- Clinical Social Worker
- Ronkonkoma, NY
National Provider Identifier
1790212660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C015714
- Practice address
- 939 Johnson Ave
Ronkonkoma, NY 11779-6066 - Phone
- (631) 471-7242
- NPI assigned
- May 22, 2017
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Social Worker | 104100000X | 104384 | NY | |
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | C015714 | NC | Primary |
Addresses
Primary practice location
939 Johnson Ave
Ronkonkoma, NY 11779-6066
Mailing address
287 Shadow Falls Dr
Wendell, NC 27591-3309
Phone (631) 912-7352
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
119 SW Maynard Rd
Cary, NC 27511-4472
Phone (919) 415-1112
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104384 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thriveworks Clinical - North Carolina PC | Current | Accepting new patients | |
| Association for Mental Health and Wellness Inc | Past | Accepting new patients |
Locations
119 SW Maynard Rd
Cary, NC 27511
Phone (919) 415-1112
1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/77c2b089-5ae8-473f-98a4-de9173e168aa/
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.
-
- Mental Health Counselor
- Raleigh, NC
- NPI 1003303082
-
- Community/Behavioral Health Agency
- Ronkonkoma, NY
- NPI 1578516738
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677715200000",
"number": "1790212660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "287 SHADOW FALLS DR",
"city": "WENDELL",
"state": "NC",
"postal_code": "275913309",
"telephone_number": "631-912-7352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "939 JOHNSON AVE",
"city": "RONKONKOMA",
"state": "NY",
"postal_code": "117796066",
"telephone_number": "631-471-7242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAAD",
"first_name": "NABEEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-22",
"last_updated": "2023-03-02",
"certification_date": "2023-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "104384",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C015714",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ronkonkoma, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.