Active NPI
Theresa Aquilina, LCSW
- Social Worker
- Sayville, NY
National Provider Identifier
1982880910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 079117-1
- Practice address
- 22-30 Railroad Ave, Suite 2
Sayville, NY 11782 - Phone
- (516) 642-3381
- NPI assigned
- Jan 22, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | P62512 | NY | |
| Social Worker | 104100000X | 079117-1 | NY | Primary |
Addresses
Primary practice location
22-30 Railroad Ave, Suite 2
Sayville, NY 11782
Mailing address
58 Sejon Dr
Sayville, NY 11782-3245
Phone (516) 642-3381
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191010002532 | NY | Practitioner - Clinical Social Worker | 7719218429 | Practice locations: Sayville, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2005
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
22 -30 Railroad Ave
Sayville, NY 11782-2795
22 Railroad Ave
Suite 30
Sayville, NY 11782-2795
Phone (516) 642-3381
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 079117-1 | NY | MD | Social Worker |
| P62512 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598832000000",
"number": "1982880910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "58 SEJON DR",
"city": "SAYVILLE",
"state": "NY",
"postal_code": "117823245",
"telephone_number": "516-642-3381",
"fax_number": "631-750-3300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22-30 RAILROAD AVE, SUITE 2",
"city": "SAYVILLE",
"state": "NY",
"postal_code": "11782",
"telephone_number": "516-642-3381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AQUILINA",
"first_name": "THERESA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-22",
"last_updated": "2020-08-31",
"certification_date": "2020-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "P62512",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "079117-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sayville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.