Individual provider Active NPI

Shaqueen Walcott

  • Social Worker
  • New York, NY
National Provider Identifier
1881092286
Registry record updated Dec 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
085895-1 Issued in NY
Practice address
135 W 50TH St
New York, NY 10020-1201
Phone
(212) 581-9100
NPI assigned
Dec 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 085895-1 NY Primary

Addresses

Primary practice location

135 W 50TH St
New York, NY 10020-1201

Mailing address

135 W 50TH St
New York, NY 10020-1201
Phone (212) 581-9100

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
I20221012001749 NY Practitioner - Clinical Social Worker 5799151064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Island Consultation Center IncGroup PAC ID 8729068622, 19 clinicians

Practice addresses (Care Compare)

9131 Queens Blvd
Suite 222
Elmhurst, NY 11373-5511
Phone (718) 896-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085895-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Consultation Center CurrentSince Jul 28, 2022 Accepting new patients
Long Island Consultation Center, Inc. CurrentSince Jul 28, 2022 Accepting new patients

Locations

9131 Queens Blvd
Ste 222
Elmhurst, NY 11373
Phone (718) 896-3400

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

Organizations & group practices 2

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": "1418774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418774400000",
    "number": "1881092286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W 50TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100201201",
            "telephone_number": "212-581-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W 50TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100201201",
            "telephone_number": "212-581-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALCOTT",
        "first_name": "SHAQUEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-17",
        "last_updated": "2014-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "085895-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.