Active NPI
Argyris M Roussos
- Social Worker
- Bay Shore, NY
National Provider Identifier
1992283279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 115318-01
- Practice address
- 1444 5TH Ave
Bay Shore, NY 11706-4147 - Phone
- (631) 647-3100
- NPI assigned
- Jul 30, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Social Worker | 104100000X | 115318-01 | NY | Primary |
Addresses
Primary practice location
1444 5TH Ave
Bay Shore, NY 11706-4147
Mailing address
91 University Heights Dr
Stony Brook, NY 11790-2731
Other practice location 1
225 Broadhollow Rd Ste 402
Melville, NY 11747-4899
Phone (631) 385-7780
Other practice location 2
100 Nicolls Rd
Stony Brook, NY 11790-3407
Phone (631) 860-8188
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
| License | State | Type | Specialty |
|---|---|---|---|
| 115318-01 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648512000000",
"number": "1992283279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 UNIVERSITY HEIGHTS DR",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117902731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1444 5TH AVE",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117064147",
"telephone_number": "631-647-3100"
}
],
"practiceLocations": [
{
"address_1": "225 Broadhollow Rd Ste 402",
"address_purpose": "LOCATION",
"city": "Melville",
"state": "NY",
"postal_code": "117474899",
"country_code": "US",
"telephone_number": "631-385-7780",
"fax_number": "631-385-7795",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 Nicolls Rd",
"address_purpose": "LOCATION",
"city": "Stony Brook",
"state": "NY",
"postal_code": "117903407",
"country_code": "US",
"telephone_number": "631-860-8188",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROUSSOS",
"first_name": "ARGYRIS",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-30",
"last_updated": "2022-03-29",
"certification_date": "2021-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "115318-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bay Shore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.