Individual provider Active NPI

Anthony Perez, LCSW MSW R

  • Clinical Social Worker
  • Garnerville, NY
National Provider Identifier
1952473944
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R28804 Issued in NY
Practice address
53 Morton St
Garnerville, NY 10923-1428
Phone
(845) 947-1357
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

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 R28804 NY Primary

Addresses

Primary practice location

53 Morton St
Garnerville, NY 10923-1428

Mailing address

53 Morton St
Garnerville, NY 10923-1428
Phone (845) 947-1357

Other identifiers 3

IdentifierTypeStateIssuer
7323442OtherOXFORD
1030790OtherBEACON
54317000OtherMAGEUAN

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
I20101119000846 NY Practitioner - Clinical Social Worker 6709072499 Practice locations: Garnerville, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

53 Morton St
Garnerville, NY 10923-1428
Phone (845) 947-1357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R28804NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952473944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 MORTON ST",
            "city": "GARNERVILLE",
            "state": "NY",
            "postal_code": "109231428",
            "telephone_number": "845-947-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 MORTON ST",
            "city": "GARNERVILLE",
            "state": "NY",
            "postal_code": "109231428",
            "telephone_number": "845-947-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "LCSW MSW R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R28804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "7323442",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON",
            "identifier": "1030790",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGEUAN",
            "identifier": "54317000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garnerville, NY

Sources for this page

Verify at the official NPI Registry.