Rudy Innocent

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1847 Mott Ave Ste 2
Far Rockaway, NY 11691-4220

Phone

(718) 337-6800

NPI assigned

Sep 7, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1831975523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1847 MOTT AVE STE 2",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914220",
            "telephone_number": "718-337-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1847 MOTT AVE STE 2",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914220",
            "telephone_number": "718-337-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INNOCENT",
        "first_name": "RUDY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• In and Out Medical P.C.
• Glenn Patrick Katigbac Inciong, PT
• Included
• Inclusive Rehab PT PC
• Inyang Bassey Inikori
• Integrated Therapeutic Services
• Island Child Development Center
• Island Emergency Medical Services, P.C.
• Island Wide Psychiatric Services PC
• Mariam Ismail, PA-C

• Social Worker in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.