Michael Jordy Rodriguez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

086539 Issued in NY

Practice address

4828 196TH PL
Fresh Meadows, NY 11365

Phone

(917) 224-1245

NPI assigned

Sep 28, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

University of Missouri, Columbia School of Medicine, 2013

Medicare assignment

May accept Medicare assignment

Group practices

New York Psychotherapy and Counseling CenterGroup PAC ID 4880600147, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New York Psychotherapy and Counseling Center

  • Community/Behavioral Health Agency
  • Jamaica, NY
  • NPI 1902811342
  Medicare reassignment Care Compare group NPD
• Bright Idea Counseling LLC

  • Clinical Social Worker
  • Huntington, NY
  • NPI 1578307658
  NPD Authorized official
• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)

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

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1013466366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4828 196TH PL",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651321",
            "telephone_number": "917-224-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4828 196TH PL",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "11365",
            "telephone_number": "917-224-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MICHAEL",
        "middle_name": "JORDY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-28",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "090124",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramona L. Robles-Villacrucis, M.A. CCC-SLP
• Javier A. Roca, MD
• Cindy Rodriguez-Sumner, MS ED, TSHH, BCBA
• Ana Maryelin Rodriguez Sr.
• Marilyn Rodriguez
• Siara Sky Rodriguez
• Ana Teresa Roldan, SLP-CCC
• Geraldine Roman
• Kristen Romani, FNP
• Tamar Rosenbaum

• Clinical Social Worker in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.