Individual provider Active NPI

Barbara Adelia Busillo, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1952406480
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00062830 Issued in NY
Practice address
887 E New York Ave
Brooklyn, NY 11203-1309
Phone
(718) 467-6441
Fax
(718) 498-6868
NPI assigned
Sep 13, 2006
Last updated
Sep 17, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P062830-1 NY
Clinical Social Worker 1041C0700X 00062830 NY Primary

Addresses

Primary practice location

887 E New York Ave
Brooklyn, NY 11203-1309

Mailing address

519 Rockaway Ave
Brooklyn, NY 11212-5638
Phone (718) 498-5555

Other identifiers 1

IdentifierTypeStateIssuer
00244931MedicaidNY

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
I20040630000623 NY Practitioner - Clinical Social Worker 4981681715 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00062830NYMDClinical Social Worker
P062830-1NYMDClinical Social Worker
062830NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
MN Psychological Services PLLC CurrentSince Aug 1, 2020 Accepting new patients
Metropolitan Psychological & Licensed Master Social Work Services PLLC Clinical PastSince Jul 31, 2020 Accepting new patients

Locations

5705 Foster Ave
Brooklyn, NY 11234
Phone (646) 457-4800

210 Beach 47th St
Far Rockaway, NY 11691
Phone (516) 447-7110

820 Front St
Hempstead, NY 11550
Phone (516) 564-1100

9502 Rockaway Beach Blvd
Rockaway Beach, NY 11693
Phone (718) 474-2478

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, 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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1952406480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 ROCKAWAY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112125638",
            "telephone_number": "718-498-5555",
            "fax_number": "718-498-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 E NEW YORK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031309",
            "telephone_number": "718-467-6441",
            "fax_number": "718-498-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSILLO",
        "first_name": "BARBARA",
        "middle_name": "ADELIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "P062830-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "00062830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244931",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.