Active NPI
Jessica Tannacore, LMSW, CASAC-T
- Social Worker
- Hicksville, NY
National Provider Identifier
1811380397
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Oct 20, 2020.
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 094437-1
- Practice address
- 950 S Oyster Bay Rd
Attn: Forensic Act Team
Hicksville, NY 11801-3510 - Phone
- (516) 822-6111
- Fax
- (516) 396-2791
- NPI assigned
- Mar 9, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 094437-1 | NY | Primary |
Addresses
Primary practice location
950 S Oyster Bay Rd
Attn: Forensic Act Team
Hicksville, NY 11801-3510
Mailing address
367 N Wellwood Ave
Lindenhurst, NY 11757-3341
Phone (631) 592-8846
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 094437-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435536000000",
"number": "1811380397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "367 N WELLWOOD AVE",
"city": "LINDENHURST",
"state": "NY",
"postal_code": "117573341",
"telephone_number": "631-592-8846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 S OYSTER BAY RD",
"address_2": "ATTN: FORENSIC ACT TEAM",
"city": "HICKSVILLE",
"state": "NY",
"postal_code": "118013510",
"telephone_number": "516-822-6111",
"fax_number": "516-396-2791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNACORE",
"first_name": "JESSICA",
"name_prefix": "Mrs.",
"credential": "LMSW, CASAC-T",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-09",
"last_updated": "2015-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "094437-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hicksville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.