Individual provider Active NPI

Christa Durkin, LCSW-R

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1902947039
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
073364-1 Issued in NY
Practice address
3930 Richmond Ave Ste 105
Staten Island, NY 10312-5104
Phone
(347) 538-2977
NPI assigned
Feb 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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 073364-1 NY Primary

Addresses

Primary practice location

3930 Richmond Ave Ste 105
Staten Island, NY 10312-5104

Mailing address

3930 Richmond Ave Ste 105
Staten Island, NY 10312-5104
Phone (347) 538-2977

Other identifiers 1

IdentifierTypeStateIssuer
03321886MedicaidNY

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
I20110607000590 NY Practitioner - Clinical Social Worker 6204013840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3930 Richmond Ave
Suite 105
Staten Island, NY 10312-5104
Phone (347) 538-2977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073364-1NYMDClinical Social Worker
060583NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Linnar Ortalan, LCSW, PC Clinical CurrentSince Sep 5, 2023 Accepting new patients
Christa Durkin, LCSW, P.C. Clinical CurrentSince May 8, 2018 Accepting new patients

Locations

3930 Richmond Ave
Ste 105
Staten Island, NY 10312
Phone (347) 538-2977

Networks

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

Interoperability endpoints

  • Direct secure messaging: cdurkin@direct.dmc.org

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": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1902947039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 RICHMOND AVE STE 105",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125104",
            "telephone_number": "347-538-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 RICHMOND AVE STE 105",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125104",
            "telephone_number": "347-538-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURKIN",
        "first_name": "CHRISTA",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-10",
        "last_updated": "2023-08-25",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073364-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03321886",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.