Individual provider Active NPI

Concepcion Pacheco, CASAC

  • Case Management Agency
  • Inwood, NY
National Provider Identifier
1982064416
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
6469 Issued in NY
Practice address
420 Doughty Blvd
Inwood, NY 11096-1357
Phone
(516) 564-2017
NPI assigned
Feb 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 6469 NY Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6469 NY

Addresses

Primary practice location

420 Doughty Blvd
Inwood, NY 11096-1357

Mailing address

101 Cedar St
Apt 207
Fort Lee, NJ 07024-7037
Phone (718) 496-1589

Other names 1

  • Ms. Concepcion Pacheco Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6469NYMDCase Management Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Recoveries R US LLC Case Management Past Accepting new patients

Organizations & group practices 1

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": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1982064416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CEDAR ST",
            "address_2": "APT 207",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070247037",
            "telephone_number": "718-496-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DOUGHTY BLVD",
            "city": "INWOOD",
            "state": "NY",
            "postal_code": "110961357",
            "telephone_number": "516-564-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "CONCEPCION",
        "credential": "CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-25",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NY",
            "license": "6469",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "6469",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONCEPCION",
            "last_name": "PACHECO",
            "prefix": "MS.",
            "credential": "CASAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Inwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.