Individual provider Active NPI

David R Donaghy, LCSW

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1841529195
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R041016 Issued in NY
Practice address
600 E Genesee St
Suite 217
Syracuse, NY 13202-2100
Phone
(315) 422-0300
Fax
(315) 479-8455
NPI assigned
Dec 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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 R041016 NY Primary

Addresses

Primary practice location

600 E Genesee St
Suite 217
Syracuse, NY 13202-2100

Mailing address

600 E Genesee St
Suite 217
Syracuse, NY 13202-2100
Phone (315) 422-0300

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
I20100609000039 NY Practitioner - Clinical Social Worker 1759411382 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R041016NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Jewish Family Service Clinical CurrentSince Mar 15, 2015 Accepting new patients

Locations

4101 E Genesee St
Syracuse, NY 13214
Phone (315) 446-9111

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": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1841529195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E GENESEE ST",
            "address_2": "SUITE 217",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022100",
            "telephone_number": "315-422-0300",
            "fax_number": "315-479-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E GENESEE ST",
            "address_2": "SUITE 217",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022100",
            "telephone_number": "315-422-0300",
            "fax_number": "315-479-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAGHY",
        "first_name": "DAVID",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-16",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R041016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.