Individual provider Active NPI

Todd Sibener, LCSW

  • Clinical Social Worker
  • Kew Gardens, NY
National Provider Identifier
1851408686
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076294 Issued in NY
Practice address
8002 Kew Gardens Rd Ste 704
Kew Gardens, NY 11415-3607
Phone
(718) 520-1513
Fax
(718) 520-6460
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 6439761 NY
Clinical Social Worker 1041C0700X 076294 NY Primary

Addresses

Primary practice location

8002 Kew Gardens Rd Ste 704
Kew Gardens, NY 11415-3607

Mailing address

320 E 85TH St
New York, NY 10028-5466

Other practice location 1

3312 Surf Ave # 30
Brooklyn, NY 11224-1406
Phone (718) 372-3300

Other identifiers 1

IdentifierTypeStateIssuer
01420795MedicaidNY

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
I20081120000038 NY Practitioner - Clinical Social Worker 0244390284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arms Acres IncGroup PAC ID 8820980691, 5 clinicians

Practice addresses (Care Compare)

9002 161St St
Jamaica, NY 11432-6108
Phone (718) 520-1513

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6439761NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Arms Acres Inc CurrentSince May 24, 2017 Accepting new patients
Arms Acres Inc CurrentSince May 24, 2017 Accepting new patients
Catholic Charities Neighborhood Services, Inc. Past Accepting new patients
Arms Acres, Inc. PastSince Jan 1, 2021 Accepting new patients
Catholic Charities Neigborhood Services Clinical Past Accepting new patients

Locations

9002 161st St
Jamaica, NY 11432
Phone (718) 520-1513

8002 Kew Gardens Rd
Ste 704
Kew Gardens, NY 11415
Phone (718) 520-1513

79 Glenridge Rd
Scotia, NY 12302
Phone (518) 952-8142

Organizations & group practices 5

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1851408686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E 85TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100285466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8002 KEW GARDENS RD STE 704",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114153607",
            "telephone_number": "718-520-1513",
            "fax_number": "718-520-6460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3312 Surf Ave # 30",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112241406",
            "country_code": "US",
            "telephone_number": "718-372-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIBENER",
        "first_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "6439761",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420795",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

Verify at the official NPI Registry.