Individual provider Active NPI

Julie M Olivencia Sanabria, MD

  • Child & Adolescent Psychiatry Physician
  • Fajardo, PR
National Provider Identifier
1053355784
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
9364 Issued in PR
Practice address
#55 Calle del Carmen
Fajardo, PR 00738
Phone
(787) 860-3558
Fax
(787) 860-3330
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 9364 PR Primary

Addresses

Primary practice location

#55 Calle del Carmen
Fajardo, PR 00738

Mailing address

PO Box 1522
Las Piedras, PR 00771-1522
Phone (787) 860-3558

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061109000556 PR Practitioner - Psychiatry 1254339062 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
N.O.R. Community Mental Health, Corp. CurrentSince Apr 6, 2009 Accepting new patients
A.P. Community Mental Services, Corp. CurrentSince Apr 1, 2011 Accepting new patients
N.O.R. Community Mental Health, Corp. Past Accepting new patients
Servicios Psicologicos Renuevate LLC Past Accepting new patients
Continuum Mental Care Corp Past Accepting new patients

Organizations & group practices 5

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1053355784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1522",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "007711522",
            "telephone_number": "787-860-3558",
            "fax_number": "787-860-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#55 CALLE DEL CARMEN",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "00738",
            "telephone_number": "787-860-3558",
            "fax_number": "787-860-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVENCIA SANABRIA",
        "first_name": "JULIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PR",
            "license": "9364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fajardo, PR

Sources for this page

Verify at the official NPI Registry.