Individual provider Active NPI

Kathleen Ann Garneau, LCSW, RN

  • Clinical Social Worker
  • Ronkonkoma, NY
National Provider Identifier
1801184429
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
083843 Issued in NY
Practice address
2040 Ocean Ave
Ronkonkoma, NY 11779-6536
Phone
(516) 282-4010
NPI assigned
Jul 17, 2011
Last updated
Oct 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 083801-1 NY
Clinical Social Worker 1041C0700X 083843 NY Primary
Registered Nurse 163W00000X 359720 NY

Addresses

Primary practice location

2040 Ocean Ave
Ronkonkoma, NY 11779-6536

Mailing address

2040 Ocean Ave
Ronkonkoma, NY 11779-6536
Phone (516) 282-4010

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
I20180607001302 NY Practitioner - Clinical Social Worker 6507121845 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Island Elder Care LCSW PLLCGroup PAC ID 8224038286, 17 clinicians

Practice addresses (Care Compare)

51 Rose St
Smithtown, NY 11787-1052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
083801-1NYMDSocial Worker
359720NYMDRegistered Nurse
083843NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Elder Care LCSW PLLC Social Worker CurrentSince Jan 8, 2019 Accepting new patients
Association for Mental Health and Wellness Inc CurrentSince May 14, 2018 Accepting new patients

Locations

939 Johnson Ave
Ronkonkoma, NY 11779
Phone (631) 471-7242

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, 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": "1310860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1801184429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 OCEAN AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117796536",
            "telephone_number": "516-282-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 OCEAN AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117796536",
            "telephone_number": "516-282-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARNEAU",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "credential": "LCSW, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-17",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "083801-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083843",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "359720",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

Verify at the official NPI Registry.