Active NPI
Pauline Rose, LCSW-R
- Clinical Social Worker
- Brooklyn, NY
National Provider Identifier
1093287195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 045329-R
- Practice address
- 858 E 29TH St
Brooklyn, NY 11210-2927 - Phone
- (718) 859-4500
- NPI assigned
- Dec 30, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 045329-R | NY | Primary |
Addresses
Primary practice location
858 E 29TH St
Brooklyn, NY 11210-2927
Mailing address
858 E 29TH St
Brooklyn, NY 11210-2927
Phone (718) 859-4500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Mar 15, 2019 through Mar 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045329-R | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546128000000",
"number": "1093287195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "858 E 29TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112102927",
"telephone_number": "718-859-4500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "858 E 29TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112102927",
"telephone_number": "718-859-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "PAULINE",
"credential": "LCSW-R",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-30",
"last_updated": "2018-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "045329-R",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.