Individual provider Active NPI

Roxanne Donaldson-Samuels

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1609598770
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
101329 Issued in NY
Practice address
672 Parkside Ave Ste 2
Brooklyn, NY 11226-2990
Phone
(718) 246-5700
NPI assigned
Sep 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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 101329 NY Primary

Addresses

Primary practice location

672 Parkside Ave Ste 2
Brooklyn, NY 11226-2990

Mailing address

672 Parkside Ave FL 2
Brooklyn, NY 11226-2298
Phone (718) 246-5700

Other practice location 1

40 Flatbush Avenue Ext
Brooklyn, NY 11201-2903
Phone (212) 271-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

292 Midwood St
Brooklyn, NY 11225-5401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111502NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1609598770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "672 PARKSIDE AVE FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262298",
            "telephone_number": "718-246-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 PARKSIDE AVE STE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262990",
            "telephone_number": "718-246-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Flatbush Avenue Ext",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112012903",
            "country_code": "US",
            "telephone_number": "212-271-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONALDSON-SAMUELS",
        "first_name": "ROXANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "101329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.