YETUNDE BAMISAYO BAMISILE (LMSW) – Social Worker, NPI 1124665609

YETUNDE BAMISAYO BAMISILE (LMSW) is a healthcare provider. based in Staten island, New York. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW. They hold a License No. 098859 (NY). The NPI Number for YETUNDE BAMISAYO BAMISILE (LMSW) is 1124665609

Main info

Female
Sole Proprietor
7 Years Of Experience
Name
YETUNDE BAMISAYO BAMISILE (LMSW)
NPI
1124665609
Phone
(718) 761-9800
Address
1765 SOUTH AVE
Enumeration Date
4 December 2019
Last Update Date
11 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4153603348
Graduation Year
2019 (7 years ago)
PAC ID
0840798591
Group Practice PAC ID
4082089461
Professional Enrollment ID
I20250812001380
Address ID
NY132063262SY2263XSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness85
Years active:6State licenses:2Digital endpointsOther names

7,009 CLINICAL SOCIAL WORKER in NY

Provider Addresses for YETUNDE BAMISAYO BAMISILE (LMSW)

  • 1765 SOUTH AVE

    STATEN ISLAND, NY 103143604

    Phone: (718) 761-9800

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250812001380IClinical Social WorkerNYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 10314)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082089461View full group profile
NameSpecialtyState
Mental Health CounselorNY
Clinical Social WorkerNY
Mental Health CounselorNY
Clinical Social WorkerNY
Nurse PractitionerNY
Clinical Social WorkerNY
Mental Health CounselorNY
Clinical PsychologistNY
Mental Health CounselorPA
Clinical Social WorkerNY

Reviews

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Frequently asked questions

Does YETUNDE BAMISAYO BAMISILE (LMSW) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — YETUNDE BAMISAYO BAMISILE (LMSW) uses 1124665609.
Does the file indicate YETUNDE BAMISAYO BAMISILE (LMSW) is practicing under active NPI?
Directory data currently reports YETUNDE BAMISAYO BAMISILE (LMSW) as active.
What is YETUNDE BAMISAYO BAMISILE (LMSW)'s specialty?
The listing groups YETUNDE BAMISAYO BAMISILE (LMSW) with Social Worker. Clinical services aligned with this taxonomy classification.
What area does YETUNDE BAMISAYO BAMISILE (LMSW) serve?
YETUNDE BAMISAYO BAMISILE (LMSW)'s listing highlights Staten Island, New York; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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