Individual provider Active NPI

Thomas Camilleri, MSW, CSW

  • Social Worker
  • Lexington, KY
National Provider Identifier
1962036319
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
253139 Issued in KY
Practice address
1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277
Phone
(859) 253-1686
NPI assigned
Feb 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 253139 KY Primary

Addresses

Primary practice location

1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277

Mailing address

1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20210506000900 KY Practitioner - Clinical Social Worker 0042629990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Vista of the Bluegrass IncGroup PAC ID 6608773619, 55 clinicians

Practice addresses (Care Compare)

201 Mechanic St
Lexington, KY 40507-1086
Phone (859) 457-8440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
253139KYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Behavioral Health LLC Current Accepting new patients
New Vista of the Bluegrass Inc Current Accepting new patients
New Vista of the Bluegrass CurrentSince Mar 1, 2021 Accepting new patients
New Vista of the Bluegrass Inc CurrentSince Mar 1, 2021 Accepting new patients
Harbor Behavioral Health LLC CurrentSince Nov 13, 2023 Accepting new patients

Locations

1351 Newtown Pike
Bldg 5
Lexington, KY 40511
Phone (859) 233-0444

1351 Newtown Pike
Bldg 1
Lexington, KY 40511
Phone (858) 253-1686

201 Mechanic St
Lexington, KY 40507
Phone (859) 233-0444

319 Duke Rd
Lexington, KY 40502
Phone (859) 489-5120

Organizations & group practices 5

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": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1962036319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 NEWTOWN PIKE BLDG 1",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 NEWTOWN PIKE BLDG 1",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111277",
            "telephone_number": "859-253-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMILLERI",
        "first_name": "THOMAS",
        "credential": "MSW, CSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-25",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "253139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.