Individual provider Active NPI

Rossemary Jimenez, LICSW

  • Clinical Social Worker
  • Lynn, MA
National Provider Identifier
1598176240
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S35898042 Issued in MA
Practice address
20 Central Ave
3Rd Floor
Lynn, MA 01901-1201
Phone
(646) 286-7603
NPI assigned
May 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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 S35898042 MA Primary

Addresses

Primary practice location

20 Central Ave
3Rd Floor
Lynn, MA 01901-1201

Mailing address

20 Central Ave
3Rd Floor
Lynn, MA 01901-1201
Phone (646) 286-7603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20240302000305 MA Practitioner - Clinical Social Worker 4284079054 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S35898042MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn Community Health, Inc. CurrentSince Jan 22, 2024 Accepting new patients

Locations

20 Central Ave
Fl 3
Lynn, MA 01901
Phone (781) 477-7222

269 Union St
Lynn, MA 01901
Phone (781) 581-9832

280 Union St
Ste 202
Lynn, MA 01901
Phone (781) 780-4555

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": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1598176240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CENTRAL AVE",
            "address_2": "3RD FLOOR",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011201",
            "telephone_number": "646-286-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CENTRAL AVE",
            "address_2": "3RD FLOOR",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011201",
            "telephone_number": "646-286-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ROSSEMARY",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-15",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "S35898042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.