Individual provider Active NPI

Richard Santos Garcia, DO

  • Clinical Psychologist
  • Juana Diaz, PR
National Provider Identifier
1043496631
Registry record updated Aug 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3056 Issued in PR
Practice address
102 Calle Tomas Carrion Maduro
Juana Diaz, PR 00795-1637
Phone
(787) 372-4999
NPI assigned
Jan 14, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 4269680 PR
Clinical Psychologist 103TC0700X 3056 PR Primary

Addresses

Primary practice location

102 Calle Tomas Carrion Maduro
Juana Diaz, PR 00795-1637

Mailing address

71 Calle Quinta Real
Juana Diaz, PR 00795-9308
Phone (787) 372-4999

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230721000091 PR Practitioner - Clinical Psychologist 2668535105 Practice locations: Juana Diaz, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4269680PRMDCounseling Psychologist
003056PRMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
RS Psychological Enterprise Clinical CurrentSince Aug 25, 2024 Accepting new patients
Home Medic Coordination Past Accepting new patients

Locations

102 Calle Tomas Carrion Maduro
Juana Diaz, PR 00795
Phone (787) 372-4999

Organizations & group practices 2

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": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724544000000",
    "number": "1043496631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 CALLE QUINTA REAL",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007959308",
            "telephone_number": "787-372-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CALLE TOMAS CARRION MADURO",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "007951637",
            "telephone_number": "787-372-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS GARCIA",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-14",
        "last_updated": "2024-08-25",
        "certification_date": "2024-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "4269680",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juana Diaz, PR

Sources for this page

Verify at the official NPI Registry.