Individual provider Active NPI

Emmanuel J Rosales, M.A., L.C.S.W.

  • Clinical Social Worker
  • Valley Stream, NY
National Provider Identifier
1932647740
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089650 Issued in NY
Practice address
22 Tulip Cir
Valley Stream, NY 11580-1927
Phone
(347) 527-8779
NPI assigned
Feb 1, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 089650 NY Primary

Addresses

Primary practice location

22 Tulip Cir
Valley Stream, NY 11580-1927

Mailing address

22 Tulip Cir
Valley Stream, NY 11580-1927
Phone (347) 527-8779

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
I20201006002668 NY Practitioner - Clinical Social Worker 3971922253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valera Medical PCGroup PAC ID 0547690521, 160 clinicians

Practice addresses (Care Compare)

134 N 4TH St
Brooklyn, NY 11249-3296
Phone (646) 450-7748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Valera Medical, P.C. Social Worker CurrentSince Mar 15, 2021 Accepting new patients
Supportive Care Psychology of Ny PC CurrentSince Mar 1, 2021 Accepting new patients
Catholic Charities Neigborhood Services Clinical Past Accepting new patients
Catholic Charities Neighborhood Services, Inc. PastSince Jul 24, 2022 Accepting new patients
Catholic Charities Neigborhood Services PastSince Nov 10, 2019 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

48 Cedar St
Brooklyn, NY 11221
Phone (718) 455-6200

134 N 4th St
Brooklyn, NY 11249

7810 164th St
Fresh Meadows, NY 11366
Phone (718) 429-2200

170 Lake St
Liberty, NY 12754
Phone (845) 292-4200

330 Chestnut St
Oneonta, NY 13820
Phone (607) 432-8500

Organizations & group practices 5

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": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1932647740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 TULIP CIR",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801927",
            "telephone_number": "347-527-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 TULIP CIR",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801927",
            "telephone_number": "347-527-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSALES",
        "first_name": "EMMANUEL",
        "middle_name": "J",
        "credential": "M.A., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-01",
        "last_updated": "2021-05-03",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.