Individual provider Active NPI

Ava Rose, LMSW

  • Social Worker
  • New York, NY
National Provider Identifier
1730690876
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
076548 Issued in NY
Practice address
1824 Madison Ave
New York, NY 10035-3832
Phone
(212) 423-4200
Fax
(646) 770-8401
NPI assigned
Oct 16, 2017
Last updated
Oct 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 076548 NY Primary

Addresses

Primary practice location

1824 Madison Ave
New York, NY 10035-3832

Mailing address

78 Elmore Ave
Englewood, NJ 07631-3318
Phone (201) 927-4060

Other identifiers 1

IdentifierTypeStateIssuer
076548OtherNYLICENSE FOR MASTER OF SOCIAL WORK

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
I20250313001352 NY Practitioner - Clinical Social Worker 8628599115 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
076548NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Institute for Family Health CurrentSince Dec 5, 2024 Accepting new patients
The Institute for Family Health Current Accepting new patients
The Institute for Family Health CurrentSince Dec 5, 2024 Accepting new patients

Locations

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

1894 Walton Ave
Bronx, NY 10453
Phone (718) 583-2508

731 White Plains Rd
Bronx, NY 10473
Phone (718) 589-8324

140 Pine St
Kingston, NY 12401
Phone (844) 434-2778

16 E 16th St
New York, NY 10003
Phone (212) 633-0800

1824 Madison Ave
New York, NY 10035
Phone (212) 423-4200

230 W 17th St
New York, NY 10011
Phone (212) 989-8999

251 W 80th St
New York, NY 10024

601 W 114th St
New York, NY 10025
Phone (212) 280-1284

690 Amsterdam Ave
New York, NY 10025
Phone (212) 865-4104

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, 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": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508112000000",
    "number": "1730690876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 ELMORE AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076313318",
            "telephone_number": "201-927-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353832",
            "telephone_number": "212-423-4200",
            "fax_number": "646-770-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "AVA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2017-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "076548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE FOR MASTER OF SOCIAL WORK",
            "identifier": "076548",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.