Individual provider Active NPI

Leeann K Medina-Martinez, LCSW

  • Clinical Social Worker
  • Melville, NY
National Provider Identifier
1851141709
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
900 Walt Whitman Rd Ste LL1
Melville, NY 11747-2215
Phone
(516) 698-5511
Fax
(516) 418-5377
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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 Primary

Addresses

Primary practice location

900 Walt Whitman Rd Ste LL1
Melville, NY 11747-2215

Mailing address

14 Pluto LN
Modena, NY 12548-5145

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
I20240423002821 NY Practitioner - Clinical Social Worker 8921447954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Talkspace Medical Services Ny PCGroup PAC ID 0143671966, 44 clinicians

Practice addresses (Care Compare)

9 Railside Ave
FL 10
White Plains, NY 10605-3408
Phone (212) 284-7206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Talkspace Medical Services Ny PC CurrentSince Jun 15, 2024 Accepting new patients

Locations

2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735

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": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1851141709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PLUTO LN",
            "city": "MODENA",
            "state": "NY",
            "postal_code": "125485145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WALT WHITMAN RD STE LL1",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472215",
            "telephone_number": "516-698-5511",
            "fax_number": "516-418-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA-MARTINEZ",
        "first_name": "LEEANN",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

Verify at the official NPI Registry.