Individual provider Active NPI

Nabeel Saad

  • Clinical Social Worker
  • Ronkonkoma, NY
National Provider Identifier
1790212660
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C015714 Issued in NC
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

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230424000420 NC Practitioner - Clinical Social Worker 7517322746 Reassigns benefits to 1 organization

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
Thriveworks Clinical - North Carolina PCGroup PAC ID 8527471200, 109 clinicians

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

LicenseStateTypeSpecialty
104384NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - North Carolina PC CurrentSince Mar 13, 2023 Accepting new patients
Association for Mental Health and Wellness Inc PastSince Apr 1, 2006 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

  • FHIR API: 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.

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

Verify at the official NPI Registry.