Individual provider Active NPI

Anna Sakharova, LCSW

  • Clinical Social Worker
  • Woodside, NY
National Provider Identifier
1790764793
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R051123 Issued in NY
Practice address
5955 47TH Ave
Apt.6B
Woodside, NY 11377-5662
Phone
(718) 672-1537
Fax
(718) 672-1537
NPI assigned
Jan 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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 R051123 NY Primary

Addresses

Primary practice location

5955 47TH Ave
Apt.6B
Woodside, NY 11377-5662

Mailing address

5955 47TH Ave
Apt.6B
Woodside, NY 11377-5662
Phone (718) 672-1537

Other identifiers 1

IdentifierTypeStateIssuer
01742745MedicaidNY

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
I20051012000830 NY Practitioner - Clinical Social Worker 7113942780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Queens Psychotherapy LCSW Services P.C.Group PAC ID 9931499639, 14 clinicians

Practice addresses (Care Compare)

9520 63Rd Rd
Suite J
Rego Park, NY 11374-1145
Phone 718459122516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R051123NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Psychotherapy LCSW Services P.C. Clinical CurrentSince Apr 7, 2016 Accepting new patients
Anna Sakharova, LCSW PC Clinical CurrentSince Apr 29, 2013 Accepting new patients
Nassau Gastroenterology Associates, P.C. Past Accepting new patients

Locations

9520 63rd Rd
Ste J
Rego Park, NY 11374
Phone (718) 459-5812

Organizations & group practices 3

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1790764793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 47TH AVE",
            "address_2": "APT.6B",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113775662",
            "telephone_number": "718-672-1537",
            "fax_number": "718-672-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 47TH AVE",
            "address_2": "APT.6B",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113775662",
            "telephone_number": "718-672-1537",
            "fax_number": "718-672-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKHAROVA",
        "first_name": "ANNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R051123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01742745",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

Verify at the official NPI Registry.