Individual provider Active NPI

Orlando Perez, R-LCSW & PSY.D.

  • Clinical Social Worker
  • Patchogue, NY
National Provider Identifier
1831403948
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29598 Issued in NY
Practice address
122 Clubhouse Dr
Patchogue, NY 11772-8202
Phone
(631) 605-3580
NPI assigned
Jul 30, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 29598 NY Primary
Clinical Psychologist 103TC0700X 29598 NY

Addresses

Primary practice location

122 Clubhouse Dr
Patchogue, NY 11772-8202

Mailing address

122 Clubhouse Dr
Patchogue, NY 11772-8202
Phone (631) 605-3580

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
I20140417001105 NY Practitioner - Clinical Social Worker 7416189881 Reassigns benefits to 1 organization
Practice locations: Patchogue, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supportive Care Psychology of Ny PCGroup PAC ID 0749536852, 49 clinicians

Practice addresses (Care Compare)

170 Lake St
Liberty, NY 12754-1966
Phone (718) 298-4375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R28598NYMDClinical Psychologist
R29598NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care Psychology of Ny PC Clinical CurrentSince Feb 19, 2024 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

7810 164th St
Fresh Meadows, NY 11366
Phone (718) 429-2200

170 Lake St
Liberty, NY 12754
Phone (845) 292-4200

330 Chestnut St
Oneonta, NY 13820
Phone (607) 432-8500

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": "1280448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1831403948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 CLUBHOUSE DR",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117728202",
            "telephone_number": "631-605-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 CLUBHOUSE DR",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117728202",
            "telephone_number": "631-605-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ORLANDO",
        "name_prefix": "Dr.",
        "credential": "R-LCSW & PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-30",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "29598",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "29598",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

Verify at the official NPI Registry.