Sheydie Enelie Vidal Plaza, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

008071 Issued in PR

Practice address

Carr. #2 KM. 39.8
Vega Baja, PR 00693

Phone

(787) 871-0601

NPI assigned

Jul 29, 2024

Last updated

Sep 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sheydie Vidal Other name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prymed Medical Care Inc

  • Clinical Medical Laboratory
  • Vega Baja, PR
  • NPI 1174914154
  NPD (past)
• Prymed Medical Care, Inc

  • Multi-Specialty Clinic/Center
  • Vega Baja, PR
  • NPI 1841605417

  Clinical

  NPD (past)
• Prymed Medical Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Ciales, PR
  • NPI 1881661866
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1053140152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 4 BOX 10578",
            "city": "UTUADO",
            "state": "PR",
            "postal_code": "006417518",
            "telephone_number": "939-460-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. #2 KM. 39.8",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "00693",
            "telephone_number": "787-871-0601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Carr 2 Km 46.7",
            "address_2": "Campo Alegre",
            "address_purpose": "LOCATION",
            "city": "Manati",
            "state": "PR",
            "postal_code": "00674",
            "country_code": "US",
            "telephone_number": "787-854-7326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIDAL PLAZA",
        "first_name": "SHEYDIE",
        "middle_name": "ENELIE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "008071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHEYDIE",
            "last_name": "VIDAL",
            "credential": "DOCTOR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Paola Crystal Velez-Roman, PHARM D
• Liza L. Velez
• Victor a. Feliz (Medtrans ambulance service)
• Victor J. Mariano Inc.
• Victor J. Mariano Inc.
• Xavier Villalobos
• Rafael Angel Villanueva
• Yelitza Villegas
• Grace Marie Vivaldi, M.A. PSYCHOLOGY
• Vivo Clinic Corp

• Clinical Psychologist in Vega Baja, PR
• Providers in Vega Baja, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.

Verify at the official NPI Registry.