Individual provider Active NPI

Roxana Yasmin Carmenate, LCSW-QS, MSW

  • Clinical Social Worker
  • Coral Springs, FL
National Provider Identifier
1861829954
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11438 Issued in FL
Practice address
9734 W Sample Rd # 200
Coral Springs, FL 33065-4004
Phone
(954) 903-1323
Fax
(954) 431-6993
NPI assigned
Oct 3, 2013
Last updated
Jul 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X SW11438 FL Primary

Addresses

Primary practice location

9734 W Sample Rd # 200
Coral Springs, FL 33065-4004

Mailing address

1831 NW 104TH Ave
Pembroke Pines, FL 33026-2354
Phone (954) 200-2545

Other practice location 1

1831 NW 104th Ave
Pembroke Pines, FL 33026-2354
Phone (954) 200-2545

Other names 1

  • Mrs. Roxana Yasmin Carmenate Pupo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211007000912 FL Practitioner - Clinical Social Worker 6204195852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neuro Wellness Centers of America, LLCGroup PAC ID 9537407382, 6 clinicians

Practice addresses (Care Compare)

9734 W Sample Rd
Coral Springs, FL 33065-4004
Phone (954) 903-1323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW11438FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Psychological Network, LLC Clinical CurrentSince Jul 23, 2023 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Jun 21, 2023 Accepting new patients
Neuro Wellness Centers of America, LLC CurrentSince Sep 13, 2021 Accepting new patients
Total Family Health Care Center Inc Mental Health PastSince Sep 13, 2021 Accepting new patients

Locations

9734 W Sample Rd
Coral Springs, FL 33065
Phone (954) 903-1323

9734 W Sample Rd
#200
Coral Springs, FL 33065
Phone (954) 903-1323

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

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": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1861829954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 NW 104TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330262354",
            "telephone_number": "954-200-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9734 W SAMPLE RD # 200",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654004",
            "telephone_number": "954-903-1323",
            "fax_number": "954-431-6993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1831 NW 104th Ave",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330262354",
            "country_code": "US",
            "telephone_number": "954-200-2545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARMENATE",
        "first_name": "ROXANA",
        "middle_name": "YASMIN",
        "name_prefix": "Ms.",
        "credential": "LCSW-QS, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROXANA",
            "last_name": "CARMENATE PUPO",
            "middle_name": "YASMIN",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.