Individual provider Active NPI

Jasmine Cerise Ceniceros, MFT

  • Marriage & Family Therapist
  • Scotia, NY
National Provider Identifier
1902541899
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
220 N Ballston Ave
Scotia, NY 12302-2533
Phone
(518) 374-3514
Fax
(518) 374-9193
NPI assigned
May 4, 2022
Last updated
May 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

220 N Ballston Ave
Scotia, NY 12302-2533

Mailing address

PO Box 1442
Troy, NY 12181-1442
Phone (518) 374-3514

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
I20240909000475 NY Practitioner - Marriage and Family Therapist 8729528559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Licensed Clinical Social Work PCGroup PAC ID 7214280049, 9 clinicians

Practice addresses (Care Compare)

220 N Ballston Ave
Scotia, NY 12302-2533
Phone (518) 374-3514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Licensed Clinical Social Work, PC Marriage & Family Therapist CurrentSince Jul 17, 2024 Accepting new patients

Locations

220 N Ballston Ave
Scotia, NY 12302
Phone (518) 374-3278

Organizations & group practices 1

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": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1902541899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1442",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121811442",
            "telephone_number": "518-374-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N BALLSTON AVE",
            "city": "SCOTIA",
            "state": "NY",
            "postal_code": "123022533",
            "telephone_number": "518-374-3514",
            "fax_number": "518-374-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CENICEROS",
        "first_name": "JASMINE",
        "middle_name": "CERISE",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-04",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scotia, NY

Sources for this page

Verify at the official NPI Registry.