Individual provider Active NPI

Marina Alexandrovna Rosin, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1336474832
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
078889-1 Issued in NY
Practice address
2114 Gravesend Neck Rd
Brooklyn, NY 11229-4810
Phone
(917) 774-6294
Fax
(718) 332-5314
NPI assigned
Oct 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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 078889-1 NY Primary

Addresses

Primary practice location

2114 Gravesend Neck Rd
Brooklyn, NY 11229-4810

Mailing address

2940 Brighton 5TH St
Apt. a
Brooklyn, NY 11235-8528
Phone (917) 774-6294

Other identifiers 1

IdentifierTypeStateIssuer
03432368MedicaidNY

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
I20120106000178 NY Practitioner - Clinical Social Worker 4385810761 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2114 Gravesend Neck Rd
FL 1
Brooklyn, NY 11229-4810
Phone (917) 774-6294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078889-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brooklyn Center for Families in Crisis Past Accepting new patients

Organizations & group practices 1

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": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1336474832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 BRIGHTON 5TH ST",
            "address_2": "APT. A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358528",
            "telephone_number": "917-774-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 GRAVESEND NECK RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294810",
            "telephone_number": "917-774-6294",
            "fax_number": "718-332-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSIN",
        "first_name": "MARINA",
        "middle_name": "ALEXANDROVNA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-16",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078889-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03432368",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.