Individual provider Active NPI

Maria De Jesus Vasquez-Rodriguez, LCSW-R

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1548416472
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
057603 Issued in NY
Practice address
260 East 188TH Street
Bronx, NY 10458-7377
Phone
(718) 960-3205
NPI assigned
Aug 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW8232 FL
Clinical Social Worker 1041C0700X 057603 NY Primary

Addresses

Primary practice location

260 East 188TH Street
Bronx, NY 10458-7377

Mailing address

260 East 188TH Street
Bronx, NY 10458
Phone (718) 960-3205

Other identifiers 1

IdentifierTypeStateIssuer
02603785MedicaidNY

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
I20180823000117 NY Practitioner - Clinical Social Worker 6204185309 Practice locations: Bronx, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW8232FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St. Barnabas Hospital Past Accepting new patients
St. Barnabas Hospital Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1548416472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 EAST 188TH STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10458",
            "telephone_number": "718-960-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 EAST 188TH STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104587377",
            "telephone_number": "718-960-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ-RODRIGUEZ",
        "first_name": "MARIA",
        "middle_name": "DE JESUS",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8232",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "057603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02603785",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.