Individual provider Active NPI

Shelby Rodgers, LCSW

  • Clinical Social Worker
  • Oakdale, NY
National Provider Identifier
1982178638
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
405 Locust Ave
Oakdale, NY 11769-1695
Phone
(631) 567-1626
NPI assigned
Jan 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 095734 NY
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

405 Locust Ave
Oakdale, NY 11769-1695

Mailing address

405 Locust Ave
Oakdale, NY 11769-1651
Phone (631) 868-1255

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
I20220513001368 NY Practitioner - Clinical Social Worker 5294112249 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nassau Psychology, P.C.Group PAC ID 1951690254, 23 clinicians

Practice addresses (Care Compare)

123 Grove Ave
Suite 216
Cedarhurst, NY 11516-2302
Phone (516) 350-8564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
095734NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Psychology, P.C. CurrentSince Sep 26, 2022 Accepting new patients
Sunrise Counseling Center,LTD Clinical CurrentSince Apr 1, 2022 Accepting new patients

Locations

123 Grove Ave
Ste 216
Cedarhurst, NY 11516
Phone (516) 569-5200

107 W Main St
East Islip, NY 11730
Phone (631) 666-1615

777 Sunrise Hwy
Ste 200
Lynbrook, NY 11563
Phone (516) 887-3516

165 N Village Ave
Ste 12
Rockville Ctr, NY 11570

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.

NPI Registry JSON

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1982178638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 LOCUST AVE",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691651",
            "telephone_number": "631-868-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LOCUST AVE",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691695",
            "telephone_number": "631-567-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "SHELBY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "095734",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, NY

Sources for this page

Verify at the official NPI Registry.