Individual provider Active NPI

Jacki Rondinella

  • Clinical Social Worker
  • Forest Hills, NY
National Provider Identifier
1174087159
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
097420 Issued in NY
Practice address
10470 Queens Blvd Ste 200
Forest Hills, NY 11375-3694
Phone
(888) 272-9355
NPI assigned
Jan 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 097420 NY Primary

Addresses

Primary practice location

10470 Queens Blvd Ste 200
Forest Hills, NY 11375-3694

Mailing address

10470 Queens Blvd Ste 200
Forest Hills, NY 11375-3694

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240828004352 NY Practitioner - Clinical Social Worker 1153860689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bleuler Psychotherapy Center IncGroup PAC ID 3274425988, 23 clinicians

Practice addresses (Care Compare)

10470 Queens Blvd
Suite 200
Forest Hills, NY 11375-3694
Phone (718) 275-6010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bleuler Psychotherapy Center, Inc. CurrentSince Jun 8, 2024 Accepting new patients
Horizon Health Services Inc PastSince Sep 1, 2019 Accepting new patients

Locations

10470 Queens Blvd
Ste 200
Forest Hills, NY 11375
Phone (866) 404-6913

3764 72nd St
Jackson Hts, NY 11372
Phone (718) 335-3434

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEGDAA
  • FHIR API: https://api.qualifacts.org/api/fhir/bleulerpc/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1174087159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 QUEENS BLVD STE 200",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10470 QUEENS BLVD STE 200",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753694",
            "telephone_number": "888-272-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONDINELLA",
        "first_name": "JACKI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.