Individual provider Active NPI

Jessica Tufo, LCSW

  • Clinical Social Worker
  • Smithtown, NY
National Provider Identifier
1922434596
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
091961 Issued in NY
Practice address
11 Route 111
Smithtown, NY 11787-3754
Phone
(631) 920-8300
NPI assigned
Sep 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 082022 NY
Clinical Social Worker 1041C0700X 091961 NY Primary

Addresses

Primary practice location

11 Route 111
Smithtown, NY 11787-3754

Mailing address

90 Middleton Rd Apt 1
Bohemia, NY 11716-3924
Phone (516) 680-0457

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
I20211006003368 NY Practitioner - Clinical Social Worker 5294133187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Welllife Network IncGroup PAC ID 0749179570, 17 clinicians

Practice addresses (Care Compare)

11 Route 111
Smithtown, NY 11787-3754
Phone (631) 920-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082022NYMDSocial Worker
091961NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Welllife Network Inc., CurrentSince Aug 27, 2021 Accepting new patients
Welllife Network Inc CurrentSince Aug 27, 2021 Accepting new patients

Locations

14202 20th Ave
Fl 3
Flushing, NY 11351
Phone (718) 559-0516

800 Northern Blvd
Great Neck, NY 11021
Phone (516) 829-8450

11 Route 111
Smithtown, NY 11787
Phone (631) 920-8300

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": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1922434596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MIDDLETON RD APT 1",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117163924",
            "telephone_number": "516-680-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ROUTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873754",
            "telephone_number": "631-920-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUFO",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "082022",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.