Individual provider Active NPI

Jerome Baldwin

  • Mental Health Counselor
  • Far Rockaway, NY
National Provider Identifier
1528784675
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1048 Beach 20TH St
Far Rockaway, NY 11691-3900
Phone
(718) 765-6342
Fax
(929) 374-1132
NPI assigned
Oct 19, 2022
Last updated
May 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NY Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

1048 Beach 20TH St
Far Rockaway, NY 11691-3900

Mailing address

PO Box 746087
Atlanta, GA 30374-6087
Phone (312) 733-9730

Other practice location 1

12012 195th St
Saint Albans, NY 11412-3718
Phone (917) 780-8597

Other practice location 2

110 Jericho Tpke Ste 212
Floral Park, NY 11001-2019
Phone (516) 263-2375

Other practice location 3

455 Sutter Ave
Brooklyn, NY 11212-8111
Phone (718) 765-6550

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
I20260603002785 NY Practitioner - Mental Health Counselor 5698246387

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Atlanta, GA 30374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health of New York Medical Group PC CurrentSince Jun 14, 2020 Accepting new patients

Locations

455 Sutter Ave
Brooklyn, NY 11212
Phone (718) 765-6550

1048 Beach 20th St
Far Rockaway, NY 11691
Phone (718) 765-6342

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, 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": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1528784675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746087",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913900",
            "telephone_number": "718-765-6342",
            "fax_number": "929-374-1132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12012 195th St",
            "address_purpose": "LOCATION",
            "city": "Saint Albans",
            "state": "NY",
            "postal_code": "114123718",
            "country_code": "US",
            "telephone_number": "917-780-8597",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Jericho Tpke Ste 212",
            "address_purpose": "LOCATION",
            "city": "Floral Park",
            "state": "NY",
            "postal_code": "110012019",
            "country_code": "US",
            "telephone_number": "516-263-2375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Sutter Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112128111",
            "country_code": "US",
            "telephone_number": "718-765-6550",
            "fax_number": "347-620-9739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "JEROME",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-19",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.