Individual provider Active NPI

Argyris M Roussos

  • Social Worker
  • Bay Shore, NY
National Provider Identifier
1992283279
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
115318-01 Issued in NY
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

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
115318-01NYMDSocial 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.

Verify at the official NPI Registry.