Individual provider Active NPI

Elizabeth D. Iseman, LCSW-R

  • Clinical Social Worker
  • Delanson, NY
National Provider Identifier
1790957553
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R028282 Issued in NY
Practice address
10284 Duanesburg Rd.
Delanson, NY 12053
Phone
(518) 872-3028
Fax
(518) 895-2615
NPI assigned
Apr 1, 2008
Last updated
Sep 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1693 NY
Clinical Social Worker 1041C0700X R028282 NY Primary

Addresses

Primary practice location

10284 Duanesburg Rd.
Delanson, NY 12053

Mailing address

Pob 70
Quaker Street, NY 12141-0070
Phone (518) 657-9061

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
I20080801000218 NY Practitioner - Clinical Social Worker 0345329827 Reassigns benefits to 1 organization
Practice locations: Delanson, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10284 Duanesburg Rd
Delanson, NY 12053-2611
Phone (518) 872-3028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R028282NYMDClinical Social Worker
028282NYMDPharmacist
1693NYMDSpeech-Language Pathologist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1790957553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POB 70",
            "city": "QUAKER STREET",
            "state": "NY",
            "postal_code": "121410070",
            "telephone_number": "518-657-9061",
            "fax_number": "518-895-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10284 DUANESBURG RD.",
            "city": "DELANSON",
            "state": "NY",
            "postal_code": "12053",
            "telephone_number": "518-872-3028",
            "fax_number": "518-895-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISEMAN",
        "first_name": "ELIZABETH",
        "middle_name": "D.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "1693",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R028282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delanson, NY

Sources for this page

Verify at the official NPI Registry.