Patricia Rena Dejesus

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

085061 Issued in NY

Practice address

29 Dogwood Dr
Middletown, NY 10940-1801

Phone

(845) 341-8008

NPI assigned

Nov 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Second Chance Counseling PLLCGroup PAC ID 6002207719, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Second Chance Counseling PLLC

  • Clinical Social Worker
  • Middletown, NY
  • NPI 1265190094
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1083217954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 DOGWOOD DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109401801",
            "telephone_number": "845-341-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 DOGWOOD DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109401801",
            "telephone_number": "845-341-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "PATRICIA",
        "middle_name": "RENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Defining Moments, LLC
• Kristen M Degeorge, BA
• Joyce Deghetto
• Shelly Dehaan, RD
• Julissa Dejesus, LPN
• Mana Dejhalla, M.D.
• Maria Delourdes Dallin, LMSW
• Ricky Demarse, LCSW
• Kimberly Marie Dembeck, P.A.
• Hui Ling Deng, MD

• Clinical Social Worker in Middletown, NY
• Providers in Middletown, 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 Aug 30, 2021; 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.