Andrew Spencer Vitale, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

103995 Issued in NY

Practice address

12314 149TH Ave
South Ozone Park, NY 11420-3714

Phone

(347) 784-2867

NPI assigned

Jul 9, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Group practices

Canino LCSW Psychotherapy, PCGroup PAC ID 2961589577, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Canino LCSW Psychotherapy PC

  • Health Maintenance Organization
  • Brooklyn, NY
  • NPI 1225220072
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1972099414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12314 149TH AVE",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203714",
            "telephone_number": "347-784-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12314 149TH AVE",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203714",
            "telephone_number": "347-784-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "ANDREW",
        "middle_name": "SPENCER",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-09",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "103995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• United Hindu Cultural Council of USA, NA Inc
• United Pharmacy Nyc Inc
• George Varghese, RPH
• Shalini Verma, MPT, PH.D
• Marybell Villa, M.A., CCC-SLP
• Wakefield Pharmacy Inc.
• Tasha Jashodra Walcott
• Walgreen Co
• Jennifer Walker, LMSW
• Millicent Yvonne Walker

• Social Worker in South Ozone Park, NY
• Providers in South Ozone Park, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.