1. Home
  2. Directory
  3. New York
  4. Mount Vernon
  5. Counselor
  6. NPI Profile

JACKI ELYSE RODRIGUEZ
NPI 1114602133
Counselor - Mental Health in Mount Vernon, NY

Active since June 19, 2023PECOS Enrolled
138 S COLUMBUS AVE FL 1, MOUNT VERNON, NY 10553(347) 398-6993 Get Directions Write a Review

NPPES record last updated: June 19, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jacki Elyse Rodriguez NPPES

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

JACKI ELYSE RODRIGUEZ (NPI 1114602133) is an individual mental health provider in Mount Vernon, New York and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1114602133
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJACKI ELYSE RODRIGUEZ
Location Address138 S COLUMBUS AVE FL 1Mount Vernon, NY 10553-1337
Mailing Address138 S Columbus Ave Fl 1Mount Vernon, NY 10553-1337 · (347) 398-6993
Phone(347) 398-6993
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJune 19, 2023
NPPES CertifiedJune 17, 2023
✔ NPI 1114602133 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
138 S COLUMBUS AVE FL 1, Mount Vernon, NY 10553
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacki Elyse Rodriguez is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4183182355
PECOS Enrollment IDI20260818002711
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 Jacki Rodriguez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PA
1,106 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, New York enrollment
  • 867 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

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 6

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

FELICE HARRIS LCSW
Social Worker (Clinical)
138 S COLUMBUS AVE FL 1
MOUNT VERNON, NY 10553
Westchester County (718) 701-3285
WINGSPAN PSYCHIATRIC, LLC
Psychiatry & Neurology (Psychiatry)
138 S COLUMBUS AVE FL 1
MOUNT VERNON, NY 10553
Westchester County (914) 413-1553
MS. RUTH M WARWICK L.C.S.W.
Social Worker
138 S COLUMBUS AVE FL 1
MOUNT VERNON, NY 10553
Westchester County (914) 509-2325
FRANCIS F. HAYDEN II MD
Psychiatry & Neurology (Psychiatry)
138 S COLUMBUS AVE FL 1
MOUNT VERNON, NY 10553
Westchester County (718) 701-3285
MR. FRANCISCO ANTONIO HIRALDO MSW
Counselor
138 S COLUMBUS AVE FL 1
MOUNT VERNON, NY 10553
Westchester County (718) 701-3285
WINGSPAN PSYCHIATRIC, LLC
Psychiatry & Neurology (Psychiatry)
138 S COLUMBUS AVE FL 1
MOUNT VERNON, NY 10553
Westchester County (718) 701-3285

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 Jacki Rodriguez's NPI number?

The NPI number for Jacki Rodriguez is 1114602133. It was assigned to this individual provider in the NPPES registry on June 19, 2023.

Where is Jacki Rodriguez located?

Jacki Rodriguez practices at 138 S Columbus Ave Fl 1, Mount Vernon, NY 10553. The listed phone number is (347) 398-6993.

What is Jacki Rodriguez's specialty?

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

Is Jacki Rodriguez enrolled in Medicare?

Yes. Jacki Rodriguez is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacki Rodriguez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacki Rodriguez reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). 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 Jacki Rodriguez'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 Jacki Rodriguez was last updated on June 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.