Active NPI
Gretchen Nicole Maldonado Rivera, PSYD
- Clinical Psychologist
- Arecibo, PR
National Provider Identifier
1023768819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 06379
- Practice address
- Carr. 635 KM 2.4 Bo. Dominguito
Arecibo, PR 00612 - Phone
- (787) 320-6327
- NPI assigned
- Mar 25, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 06379 | PR | Primary |
Addresses
Primary practice location
Carr. 635 KM 2.4 Bo. Dominguito
Arecibo, PR 00612
Mailing address
PO Box 143862
Arecibo, PR 00614-3862
Phone (787) 320-6327
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240812003866 | PR | Practitioner - Clinical Psychologist | 9638617483 | Practice locations: Arecibo, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06379 | PR | MD | Clinical Psychologist |
| 6379 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710288000000",
"number": "1023768819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 143862",
"city": "ARECIBO",
"state": "PR",
"postal_code": "006143862",
"telephone_number": "787-320-6327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR. 635 KM 2.4 BO. DOMINGUITO",
"city": "ARECIBO",
"state": "PR",
"postal_code": "00612",
"telephone_number": "787-320-6327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO RIVERA",
"first_name": "GRETCHEN",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-25",
"last_updated": "2024-03-13",
"certification_date": "2024-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "06379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arecibo, PR
- Elimer Maldonado Colon
- Angel Luis Maldonado Despiau
- Antonio M. Maldonado Gonzalez, M.D.
- Eduardo Javier Maldonado Molinari, DC
- Mariana Del Pilar Maldonado Planell, DMD
- Eva Haydee Maldonado Varela, PSY D
- Juan Carlos Maldonado-Melendez, M.D.
- Carmen Jasmin Maldonado
- Janet Aileen Maldonado, RPH
- Jose Carlos Maldonado, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.