Tara Anglim, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R071724-1 Issued in NY

Practice address

166 Gerritsen Ave
Bayport, NY 11705-2162

Phone

(631) 944-2909

NPI assigned

Oct 27, 2012

Last updated

Oct 27, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peconic Bay Primary Medical Care

  dba Same

  • Internal Medicine Physician
  • Mattituck, NY
  • NPI 1487620613
  NPD

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

{
    "created_epoch": "1351296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351296000000",
    "number": "1861746919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 GERRITSEN AVE",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117052162",
            "telephone_number": "631-944-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 GERRITSEN AVE",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117052162",
            "telephone_number": "631-944-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGLIM",
        "first_name": "TARA",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-27",
        "last_updated": "2012-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R071724-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Alexandersen
• Lindsay Christine Alimena, D.M.D
• Mary Anderson, LCSWR
• Nancy A Anderson, MACCSLP TSHH
• Kim M Andrunik, RN
• Shahla Arif
• Emily Arntsen
• Emily Michelle Arpino, MSW
• Autism Behavior Consulting, LLC
• Imtisal Awan

• Clinical Social Worker in Bayport, NY
• Providers in Bayport, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.