Individual provider Active NPI

Rosa M Rosado Campbell, LCSW

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1497069652
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R028927-1 Issued in NY
Practice address
4123 3Rd Ave
Bronx, NY 10457-6222
Phone
(718) 299-9304
Fax
(646) 565-9491
NPI assigned
Jul 29, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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 R028927-1 NY Primary

Addresses

Primary practice location

4123 3Rd Ave
Bronx, NY 10457-6222

Mailing address

145 W 15TH St FL 67012
New York, NY 10011-6701
Phone (212) 924-6320

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
I20130807000010 NY Practitioner - Clinical Social Worker 6406098276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Puerto Rican Family Institute, Inc. 10 clinicians

Practice addresses (Care Compare)

130 W Tremont Ave
Bronx, NY 10453-5436
Phone (718) 299-3045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R028927-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Puerto Rican Family Institute, Inc. CurrentSince Mar 4, 2013 Accepting new patients
Puerto Rican Family Institute, Inc. CurrentSince Mar 4, 2013 Accepting new patients
Puerto Rican Family Institute, Inc. Current Accepting new patients

Locations

4123 3rd Ave
Bronx, NY 10457
Phone (718) 299-3045

130 W Tremont Ave
Bronx, NY 10453
Phone (718) 299-3045

145 W 15th St
#2
New York, NY 10011
Phone (212) 924-6320

Organizations & group practices 3

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": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1497069652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 W 15TH ST FL 67012",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116701",
            "telephone_number": "212-924-6320",
            "fax_number": "646-306-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104576222",
            "telephone_number": "718-299-9304",
            "fax_number": "646-565-9491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSADO CAMPBELL",
        "first_name": "ROSA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-29",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R028927-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.