Gina Marie Divincenzo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

PR058073-1 Issued in NY

Practice address

175 Jericho Tpke
Ste 213
Syosset, NY 11791-4501

Phone

(631) 316-3965

NPI assigned

Dec 8, 2006

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

Other identifiers 2

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

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Catholic Charities of the Diocese of Rockville Centre

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Freeport, NY
  • NPI 1831110972
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1912066416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 KELSEY AVE",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461136",
            "telephone_number": "631-316-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 JERICHO TPKE",
            "address_2": "STE 213",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914501",
            "telephone_number": "631-316-3965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVINCENZO",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR058073-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER #",
            "identifier": "MHS#568767",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER #",
            "identifier": "P3675881",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David C. Dillon, M.D.
• Randolph P Dilorenzo, M.D.
• Alaina Nicole Dimitriou
• Direct Therapy Referral Services Inc.
• Maryann Ditraglia, MSED
• Aditya Pinang Doctor
• Dombroff & Dos Santos DMDS PLLC
• Elliott Jay Dombroff, D.M.D.
• Celestino Marques Dossantos, DMD
• Logan Carol Dowd

• Clinical Social Worker in Syosset, NY
• Providers in Syosset, 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 Sep 1, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.