Individual provider Active NPI

Lisa Jovana Orbegoso

  • Social Worker
  • Forest Hills, NY
National Provider Identifier
1962726372
Registry record updated Mar 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
073058 Issued in NY
Practice address
11133 76TH Dr
Forest Hills, NY 11375-7005
Phone
(347) 668-9502
NPI assigned
Mar 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2010

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 073058 NY Primary

Addresses

Primary practice location

11133 76TH Dr
Forest Hills, NY 11375-7005

Mailing address

11133 76TH Dr
Forest Hills, NY 11375-7005
Phone (347) 668-9502

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
I20120907000544 NY Practitioner - Clinical Social Worker 0143478610 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073058NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Healthcare, Inc. CurrentSince Jul 16, 2018 Accepting new patients
Mead Counseling LCSW PLLC Past Accepting new patients

Locations

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

21111 Northern Blvd
#13292
Bayside, NY 11361
Phone (718) 705-1000

3060 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1790

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

220 E 42nd St
Fl 8
New York, NY 10017
Phone (212) 273-2761

Interoperability endpoints

  • Direct secure messaging: lisa.orbegoso.p1@direct.premierhealthcare.nextgenshare.com

Organizations & group practices 3

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": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1962726372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11133 76TH DR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757005",
            "telephone_number": "347-668-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11133 76TH DR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757005",
            "telephone_number": "347-668-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORBEGOSO",
        "first_name": "LISA",
        "middle_name": "JOVANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "073058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.