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NINA-SYMONE FREDERICK
NPI 1043875701
Counselor - Mental Health in Bronx, NY

Active since May 07, 2019PECOS Enrolled
579 COURTLANDT AVE, BRONX, NY 10451(718) 485-2100 Get Directions Write a Review

NPPES record last updated: May 7, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Nina-symone Frederick NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NINA-SYMONE FREDERICK (NPI 1043875701) is an individual mental health provider in Bronx, New York and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1043875701
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameNINA-SYMONE FREDERICK
Location Address579 COURTLANDT AVEBronx, NY 10451-5013
Mailing Address3 Sherwood Ter Apt 3jYonkers, NY 10704-3349 · (917) 697-9955
Phone(718) 485-2100
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMay 7, 2019
✔ NPI 1043875701 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
579 COURTLANDT AVE, Bronx, NY 10451
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nina-symone Frederick is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3173966132
PECOS Enrollment IDI20240206003726
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Nina-symone Frederick reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

New York Psychotherapy And Counseling Center
13 mi
Community/Behavioral Health
17620 148TH AVE
Jamaica, NY 11434
  • Reassigned Medicare billing, New York enrollment
  • 249 clinicians in this Medicare group
NPI 1902811342 (718) 553-1100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ILIANA PAOLA MEDINA
Social Worker
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
KELVIN OLIVO
Counselor (Mental Health)
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
MS. RHAZEEL JANGLERI PLATA
Counselor (Mental Health)
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
VANESSA BAEZ
Social Worker
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
MS. JOMAIRA LUZ MARTINEZ LMSW
Social Worker (Clinical)
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
RENNY JASMIN RIVERA
Social Worker
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
ASHEA ACEVEDO
Counselor (Mental Health)
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100
SARAH JENSEN MHC
Counselor (Mental Health)
579 COURTLANDT AVE
BRONX, NY 10451
Bronx County (718) 485-2100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nina-symone Frederick's NPI number?

The NPI number for Nina-symone Frederick is 1043875701. It was assigned to this individual provider in the NPPES registry on May 7, 2019.

Where is Nina-symone Frederick located?

Nina-symone Frederick practices at 579 Courtlandt Ave, Bronx, NY 10451. The listed phone number is (718) 485-2100.

What is Nina-symone Frederick's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Nina-symone Frederick enrolled in Medicare?

Yes. Nina-symone Frederick is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nina-symone Frederick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nina-symone Frederick reassigns Medicare benefits to New York Psychotherapy And Counseling Center (Jamaica, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nina-symone Frederick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nina-symone Frederick was last updated on May 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.