Individual provider Active NPI

Brandi Rochelle Perusomala, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1801875315
Registry record updated Oct 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
073950 Issued in NY
Practice address
340 E 24TH St
New York, NY 10010-4019
Phone
(212) 585-6000
Fax
(212) 585-6161
NPI assigned
Jan 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2010

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 073950 NY Primary

Addresses

Primary practice location

340 E 24TH St
New York, NY 10010-4019

Mailing address

206 W 148TH St Apt 3N
New York, NY 10039-3129
Phone (917) 573-5261

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
I20201110002742 NY Practitioner - Clinical Social Worker 0345595369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Columbia University College of Physicians and Surgeons, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 Elm St
Cornwall, NY 12518-1485
Phone (845) 202-0715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brandi Perusomala LCSW PLLC Clinical CurrentSince Sep 1, 2020 Accepting new patients
Michele Winchester-Vega LCSW PLLC Clinical PastSince Mar 14, 2016 Accepting new patients

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286323200000",
    "number": "1801875315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 W 148TH ST APT 3N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100393129",
            "telephone_number": "917-573-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 E 24TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104019",
            "telephone_number": "212-585-6000",
            "fax_number": "212-585-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERUSOMALA",
        "first_name": "BRANDI",
        "middle_name": "ROCHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-12",
        "last_updated": "2010-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.