Individual provider Active NPI

Jinselly Abreu Rosa

  • Social Worker
  • Forest Hills, NY
National Provider Identifier
1164116307
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
P135999 Issued in NY
Practice address
6735 112TH St
Forest Hills, NY 11375-2349
Phone
(646) 907-5146
NPI assigned
Jun 8, 2023
Last updated
Jun 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X P135999 NY Primary

Addresses

Primary practice location

6735 112TH St
Forest Hills, NY 11375-2349

Mailing address

893 Old Medford Ave
Medford, NY 11763-2660
Phone (917) 640-0353

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P135999NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1164116307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "893 OLD MEDFORD AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632660",
            "telephone_number": "917-640-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6735 112TH ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752349",
            "telephone_number": "646-907-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABREU ROSA",
        "first_name": "JINSELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-08",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "P135999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.