Individual provider Active NPI

Ernest Leuci, LCSWR

  • Clinical Social Worker
  • PRT Jeff Sta, NY
National Provider Identifier
1821047002
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR053666-1 Issued in NY
Practice address
3 Premier CT
PRT Jeff Sta, NY 11776-3198
Phone
(631) 476-7119
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 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 PR053666-1 NY Primary

Addresses

Primary practice location

3 Premier CT
PRT Jeff Sta, NY 11776-3198

Mailing address

3 Premier CT
PRT Jeff Sta, NY 11776-3198
Phone (631) 476-7119

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
I20060505000351 NY Practitioner - Clinical Social Worker 2062423098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Stony Brook, School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ernest Leuci LCSW PCGroup PAC ID 8325041874, 2 clinicians

Practice addresses (Care Compare)

3 Premier CT
Port Jefferson Station, NY 11776-3198
Phone (633) 476-7119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR053666-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ernest Leuci LCSW PC Clinical CurrentSince Aug 15, 2002 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1821047002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PREMIER CT",
            "city": "PRT JEFF STA",
            "state": "NY",
            "postal_code": "117763198",
            "telephone_number": "631-476-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PREMIER CT",
            "city": "PRT JEFF STA",
            "state": "NY",
            "postal_code": "117763198",
            "telephone_number": "631-476-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUCI",
        "first_name": "ERNEST",
        "name_prefix": "Mr.",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR053666-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in PRT Jeff Sta, NY

Sources for this page

Verify at the official NPI Registry.