Carmen J Jimenez, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

R0367271 Issued in NY

Practice address

10501 34TH Avenue
Corona, NY 11368-1109

Phone

(718) 458-7818

Fax

(718) 458-7818

NPI assigned

Jan 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

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.

• Protect the Angels Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Corona, NY
  • NPI 1114599875
  NPD Authorized official

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668211200000",
    "number": "1114074580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 34TH AVENUE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681109",
            "telephone_number": "718-458-7818",
            "fax_number": "718-458-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10501 34TH AVENUE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681109",
            "telephone_number": "718-458-7818",
            "fax_number": "718-458-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "CARMEN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2022-11-12",
        "certification_date": "2022-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "R0367271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02265341",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Joanne Jara, BA
• Marie Javier
• Jean Joseph Lochard MD PC
• Selina Jiang
• Xiao Fang Jiang
• John B Halkias Physician PC
• Diana Johnson
• Paul Jones Jr, D.D.S., M.S.
• George Miller Jones
• JS Health Inc

• Social Worker in Corona, NY
• Providers in Corona, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.