Individual provider Active NPI

Susan Fitzsimmons, LCSW

  • Clinical Social Worker
  • Bedford Hills, NY
National Provider Identifier
1962137372
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
093609-01 Issued in NY
Practice address
101 Springhurst Rd
Bedford Hills, NY 10507-2216
Phone
(914) 282-3042
NPI assigned
Jul 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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 093609-01 NY Primary

Addresses

Primary practice location

101 Springhurst Rd
Bedford Hills, NY 10507-2216

Mailing address

101 Springhurst Rd
Bedford Hills, NY 10507-2216
Phone (914) 282-3042

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
I20241216001370 NY Practitioner - Clinical Social Worker 5698201531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

701 N Broadway
Sleepy Hollow, NY 10591-1020
Phone (914) 366-3000

Hospital & facility affiliations

  • Phelps Hospital Hospital, Sleepy Hollow, NY, CCN 330261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
093609-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Nov 1, 2024 Accepting new patients
North Shore-Lij Medical PC CurrentSince Nov 1, 2024 Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1962137372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SPRINGHURST RD",
            "city": "BEDFORD HILLS",
            "state": "NY",
            "postal_code": "105072216",
            "telephone_number": "914-282-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SPRINGHURST RD",
            "city": "BEDFORD HILLS",
            "state": "NY",
            "postal_code": "105072216",
            "telephone_number": "914-282-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZSIMMONS",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093609-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford Hills, NY

Sources for this page

Verify at the official NPI Registry.