Kristofer Mark Isaksen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

096585 Issued in NY

Practice address

2277 Grand Ave
Baldwin, NY 11510-3148

Phone

(516) 377-5400

Fax

(516) 377-5490

NPI assigned

Jul 11, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCJFAD

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.

• Comprehensive Counseling LCSW, PLLC

  • Clinical Social Worker
  • Bayside, NY
  • NPI 1982798773
  Medicare reassignment NPD
• Long Island Select Healthcare, Inc.

  dba LISH, Inc.

  • Federally Qualified Health Center (FQHC)
  • Central Islip, NY
  • NPI 1043663107
  Medicare reassignment NPD
• Aldad Medical PC

  • Psychiatry Physician
  • Ann Arbor, MI
  • NPI 1174784953

  NY

  Medicare reassignment NPD
• Long Island Select Healthcare, Inc.

  dba LISH, Inc.

  • Federally Qualified Health Center (FQHC)
  • Manorville, NY
  • NPI 1518310689
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1790337590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BLUETOP RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331906",
            "telephone_number": "631-942-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 GRAND AVE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103148",
            "telephone_number": "516-377-5400",
            "fax_number": "516-377-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAKSEN",
        "first_name": "KRISTOFER",
        "middle_name": "MARK",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-11",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "104745",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gertlean Hunter
• Gloria Ikechukwu, DNP
• Indigo Dove LCSW Therapy Wellness PC
• Integrity Treatment Partners LLC
• Irfan a Alladin, MD PC (Pain Medicine of New York)
• Ivu, LLC
• Bernadette Jackson, RN
• Rosa Lee Jackson, LPN
• Marc Louis Jacobs, D.C.
• Suze Paul Jacques

• Clinical Social Worker in Baldwin, NY
• Providers in Baldwin, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.