Active NPI
Jasmine Rodriguez
- Social Worker
- Staten Island, NY
National Provider Identifier
1174490262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 128310
- Practice address
- 831 Van Duzer St
Staten Island, NY 10304-1874 - Phone
- (347) 440-6878
- Fax
- (347) 440-6878
- NPI assigned
- Oct 22, 2025
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 128310 | NY | Primary |
Addresses
Primary practice location
831 Van Duzer St
Staten Island, NY 10304-1874
Mailing address
308 Magnolia Ave
Elizabeth, NJ 07206-1913
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
| License | State | Type | Specialty |
|---|---|---|---|
| 128310 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761091200000",
"number": "1174490262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 MAGNOLIA AVE",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072061913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "831 VAN DUZER ST",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103041874",
"telephone_number": "347-440-6878",
"fax_number": "347-440-6878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "JASMINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-10-22",
"last_updated": "2025-10-22",
"certification_date": "2025-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "NY",
"license": "128310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.