Individual provider Active NPI

Guadalupe Rodrigues

  • Clinical Social Worker
  • Jamaica, NY
National Provider Identifier
1437677937
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
095642 Issued in NY
Practice address
163-18 Jamaica Ave 2FL
Jamaica, NY 11432-1020
Phone
(718) 659-4000
Fax
(718) 659-1405
NPI assigned
Sep 5, 2017
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 105329 NY
Clinical Social Worker 1041C0700X 095642 NY Primary

Addresses

Primary practice location

163-18 Jamaica Ave 2FL
Jamaica, NY 11432-1020

Mailing address

22011 92ND Ave
Queens Village, NY 11428-1356
Phone (347) 922-0731

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
I20230927000797 NY Practitioner - Clinical Social Worker 0547614471 Reassigns benefits to 2 organizations

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
The Child Center of Ny IncGroup PAC ID 8426010638, 15 clinicians

Practice addresses (Care Compare)

16318 Jamaica Ave
Suite 2
Jamaica, NY 11432-4901
Phone (718) 358-8288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105329NYMDSocial Worker
095642NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Child Center of Ny, Inc. CurrentSince Jul 8, 2023 Accepting new patients

Locations

11835 Queens Blvd
Fl 6
Forest Hills, NY 11375
Phone (718) 851-7770

11515 Sutphin Blvd
Jamaica, NY 11434
Phone (718) 659-4000

16318 Jamaica Ave
Ste 2
Jamaica, NY 11432
Phone (718) 297-8000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1437677937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22011 92ND AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281356",
            "telephone_number": "347-922-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163-18 JAMAICA AVE 2FL",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321020",
            "telephone_number": "718-659-4000",
            "fax_number": "718-659-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUES",
        "first_name": "GUADALUPE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "105329",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.