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MR. SAMUEL WILLIAMS LMSW
NPI 1174917934
Social Worker in Staten Island, NY

Active since March 19, 2015PECOS Enrolled
2795 RICHMOND AVE, STATEN ISLAND, NY 10314(718) 761-9800(718) 370-1142 Get Directions Write a Review

NPPES record last updated: March 19, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mr. Samuel Williams Lmsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. SAMUEL WILLIAMS LMSW (NPI 1174917934) is an individual social worker in Staten Island, New York, licensed in New York (087085-1) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS and is a graduate of Other (2009).

NPPES Registry Identity

NPI1174917934
Entity TypeIndividualMale
Primary Taxonomy104100000X
Provider Legal NameMR. SAMUEL WILLIAMSCredential: LMSW
Location Address2795 RICHMOND AVEStaten Island, NY 10314-5866
Mailing Address2795 Richmond AveStaten Island, NY 10314-5866 · (718) 761-9800 · Fax (718) 370-1142
Phone(718) 761-9800
Fax(718) 370-1142
Sole ProprietorYes
Medical School CMSOtherGraduated 2009
Enumeration DateMarch 19, 2015
✔ NPI 1174917934 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in NY · 087085-1
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
2795 RICHMOND AVE, Staten Island, NY 10314
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Other Names 1

Other Name (5)Mr. Samuel Lee Williams Lmsw

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Samuel Williams Lmsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID749740652
PECOS Enrollment IDI20260831004823
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Samuel Williams reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Medical Services Of Northeastern Queens PLLC
22 mi
Internal Medicine
9131 175TH ST
Jamaica, NY 11432
  • Reassigned Medicare billing, New York enrollment
  • 61 clinicians in this Medicare group
NPI 1184311441 (718) 709-0940

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEVEN JULIEN
Social Worker
2795 RICHMOND AVE
STATEN ISLAND, NY 10314
Richmond County (718) 982-6982
TONYA MUSTIPHER MSW
Social Worker
2795 RICHMOND AVE
STATEN ISLAND, NY 10314
Richmond County (718) 982-6982
JOANNE MCLEAN
Social Worker
2795 RICHMOND AVE
STATEN ISLAND, NY 10314
Richmond County (718) 761-9800
MRS. KAREN ANN DWYER-TESORIERO LCSW
Social Worker (Clinical)
2795 RICHMOND AVE
STATEN ISLAND, NY 10314
Richmond County (718) 761-9800
TONEAKQUA CARDONA B.P.S.
Case Management
2795 RICHMOND AVE
STATEN ISLAND, NY 10314
Richmond County (718) 982-6982
ROSALIE MOLINARI LMSW
Social Worker
2795 RICHMOND AVE
STATEN ISLAND, NY 10314
Richmond County (718) 761-9800
SHARON JACKSON
Case Manager/Care Coordinator
2795 RICHMOND AVE
STATEN ISLAND, NY 10314
Richmond County (718) 761-9800
GREG SANDLER
Student in an Organized Health Care Education/Training Program
2795 RICHMOND AVE
STATEN ISLAND, NY 10314
Richmond County (718) 761-9800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Williams's NPI number?

The NPI number for Samuel Williams is 1174917934. It was assigned to this individual provider in the NPPES registry on March 19, 2015. The provider is also known as Mr. Samuel Lee Williams Lmsw.

Where is Samuel Williams located?

Samuel Williams practices at 2795 Richmond Ave, Staten Island, NY 10314. The listed phone number is (718) 761-9800.

What is Samuel Williams's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Samuel Williams enrolled in Medicare?

Yes. Samuel Williams is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Samuel Williams's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Williams reassigns Medicare benefits to Medical Services Of Northeastern Queens PLLC (Jamaica, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Williams's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Samuel Williams was last updated on March 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.