Individual provider Active NPI

Antoinette Bullara-Santangelo, CSW

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1932287513
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
040447 Issued in NY
Practice address
14 Monterey Ave
Staten Island, NY 10312-2066
Phone
(718) 494-3535
NPI assigned
Nov 1, 2006
Last updated
Jan 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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 040447 NY Primary

Addresses

Primary practice location

14 Monterey Ave
Staten Island, NY 10312-2066

Mailing address

14 Monterey Ave
Staten Island, NY 10312-2066
Phone (718) 494-3535

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
I20060217000523 NY Practitioner - Clinical Social Worker 2062427610 Practice locations: Staten Island, 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

Practice addresses (Care Compare)

14 Monterey Ave
Staten Island, NY 10312-2066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040447NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Linnar Ortalan, LCSW, PC Clinical Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1932287513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MONTEREY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122066",
            "telephone_number": "718-494-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MONTEREY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122066",
            "telephone_number": "718-494-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARA-SANTANGELO",
        "first_name": "ANTOINETTE",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "040447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.