Individual provider Active NPI

John Stanolevich, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1811062540
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R055401 Issued in NY
Practice address
83 Maiden LN
New York, NY 10038-4812
Phone
(212) 780-2366
Fax
(212) 777-3918
NPI assigned
Nov 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R055401 NY Primary

Addresses

Primary practice location

83 Maiden LN
New York, NY 10038-4812

Mailing address

6936 169TH St
Fresh Meadows, NY 11365-3325
Phone (718) 591-5649

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
I20070504000055 NY Practitioner - Clinical Social Worker 8921104100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Nysarc Inc. Nyc ChapterGroup PAC ID 7214030634, 20 clinicians

Practice addresses (Care Compare)

83 Maiden LN
New York, NY 10038-4812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R055401NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc New York City Chapter CurrentSince Jul 17, 2006 Accepting new patients
Ahrc Healthcare Inc. Past Accepting new patients

Locations

83 Maiden Ln
New York, NY 10038
Phone (212) 780-2578

83 Maiden Ln
Fl 7
New York, NY 10038
Phone (212) 780-2564

83 Maiden Ln
Fl 8
New York, NY 10038
Phone (212) 895-3477

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811062540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6936 169TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653325",
            "telephone_number": "718-591-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 MAIDEN LN",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384812",
            "telephone_number": "212-780-2366",
            "fax_number": "212-777-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANOLEVICH",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R055401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.