Individual provider Active NPI

Jose Angel Rodriguez, LCSW

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1003142233
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081480 Issued in NY
Practice address
305 East 161St
C/O Montefiore
Bronx, NY 10451
Phone
(718) 410-3561
Fax
(718) 410-3629
NPI assigned
Oct 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X NY
Clinical Social Worker 1041C0700X 081480 NY Primary

Addresses

Primary practice location

305 East 161St
C/O Montefiore
Bronx, NY 10451

Mailing address

110 W 97TH St
C/O William F. Ryan Community Health Center
New York, NY 10025-6450
Phone (212) 749-1820

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
081480NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1003142233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 97TH ST",
            "address_2": "C/O WILLIAM F. RYAN COMMUNITY HEALTH CENTER",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256450",
            "telephone_number": "212-749-1820",
            "fax_number": "212-932-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 EAST 161ST",
            "address_2": "C/O MONTEFIORE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10451",
            "telephone_number": "718-410-3561",
            "fax_number": "718-410-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOSE",
        "middle_name": "ANGEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-22",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.