Individual provider Active NPI

Yajaira Rosa

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1740727403
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090608 Issued in NY
Practice address
975 Westchester Ave
Bronx, NY 10459-3204
Phone
(718) 320-4466
Fax
(718) 991-3829
NPI assigned
Jan 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 094218-1 NY
Clinical Social Worker 1041C0700X 090608 NY Primary

Addresses

Primary practice location

975 Westchester Ave
Bronx, NY 10459-3204

Mailing address

60 Madison Ave
5TH Floor
New York, NY 10010-1600
Phone (212) 545-2439

Other identifiers 1

IdentifierTypeStateIssuer
00695941MedicaidNY

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
I20210126000164 NY Practitioner - Clinical Social Worker 3678987138 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Healthcare Network IncGroup PAC ID 7416855143, 83 clinicians

Practice addresses (Care Compare)

1002 Westchester Ave
Bronx, NY 10459-3204
Phone (718) 320-4466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
094218-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Valera Medical, P.C. Social Worker CurrentSince Mar 8, 2021 Accepting new patients
Community Healthcare Network, Inc. CurrentSince Jan 3, 2024 Accepting new patients

Locations

1002 Westchester Ave
Bronx, NY 10459
Phone (718) 320-4466

2581 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 495-6700

134 N 4th St
Brooklyn, NY 11249

3611 21st St
Long Island City, NY 11106
Phone (718) 482-7488

44 W 28th St
Fl 5
New York, NY 10001
Phone (212) 545-2439

60 Madison Ave
Fl 5
New York, NY 10010
Phone (212) 545-2400

255 E Houston St
New York, NY 10002
Phone (212) 477-1120

511 W 157th St
New York, NY 10032
Phone (212) 781-7979

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1740727403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MADISON AVE",
            "address_2": "5TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100101600",
            "telephone_number": "212-545-2439",
            "fax_number": "646-312-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 WESTCHESTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593204",
            "telephone_number": "718-320-4466",
            "fax_number": "718-991-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSA",
        "first_name": "YAJAIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "094218-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.