Individual provider Active NPI

Fran Ellen Siegal Sr., LCSW

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1982766457
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO23544-1 Issued in NY
Practice address
2021 Grand Concourse
Bronx, NY 10453-4304
Phone
(718) 960-0314
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 RO23544-1 NY Primary

Addresses

Primary practice location

2021 Grand Concourse
Bronx, NY 10453-4304

Mailing address

26 E 10TH St
New York, NY 10003-5945

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
I20200817002674 NY Practitioner - Clinical Social Worker 3870919111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Mark's Place Institute for Mental Health IncGroup PAC ID 4688565740, 17 clinicians

Practice addresses (Care Compare)

57 Saint Marks PL
New York, NY 10003-7902
Phone (212) 982-3470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO23544-1NYMDClinical Social Worker
023544NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mark's Place Institute for Mental Health, Inc CurrentSince Jul 1, 2020 Accepting new patients

Locations

57 Saint Marks Pl
New York, NY 10003
Phone (212) 982-3470

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982766457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 E 10TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100035945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534304",
            "telephone_number": "718-960-0314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGAL",
        "first_name": "FRAN",
        "middle_name": "ELLEN",
        "name_suffix": "Sr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO23544-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.