Individual provider Active NPI

Mary C. Ragan, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1912115064
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR040726-1 Issued in NY
Practice address
401 East 74TH Street
Apt. 7L
New York, NY 10021-3927
Phone
(212) 794-3095
Fax
(212) 794-3095
NPI assigned
May 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PR040726-1 NY Primary

Addresses

Primary practice location

401 East 74TH Street
Apt. 7L
New York, NY 10021-3927

Mailing address

401 East 74TH Street
Apt. 7L
New York, NY 10021-3927
Phone (212) 794-3095

Other identifiers 1

IdentifierTypeStateIssuer
PR040726-1OtherNYLCSW

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
I20101102000702 NY Practitioner - Clinical Social Worker 4385838515 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

401 E 74 St
New York, NY 10021-3927
Phone (212) 794-3095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR040726-1NYMDClinical Social Worker
040726NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912115064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 EAST 74TH STREET",
            "address_2": "APT. 7L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213927",
            "telephone_number": "212-794-3095",
            "fax_number": "212-794-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 EAST 74TH STREET",
            "address_2": "APT. 7L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213927",
            "telephone_number": "212-794-3095",
            "fax_number": "212-794-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGAN",
        "first_name": "MARY",
        "middle_name": "C.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR040726-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "PR040726-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.