Individual provider Active NPI

Wilfredo Aviles Ortega, PSYD

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1063221869
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8101 Issued in PR
Practice address
Urb. Villa Grillasca 2178 Blvd. Luis a. Ferre
Ponce, PR 00717-0722
Phone
(939) 588-1806
NPI assigned
Jan 6, 2025
Last updated
May 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 8101 PR Primary

Addresses

Primary practice location

Urb. Villa Grillasca 2178 Blvd. Luis a. Ferre
Ponce, PR 00717-0722

Mailing address

Estancias de Monte Rio 21 Calle Heliconia
Cayey, PR 00736
Phone (787) 420-4491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260523000275 PR Practitioner - Psychologist Billing Independently 9739659491 Practice locations: Ponce, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Ponce School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2178 Blvd Luis a Ferre
Ponce, PR 00717-0722
Phone (939) 588-1806

Est Monte Rio 21 Calle Heliconia
Cayey, PR 00736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8101PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Diaz Medero LLC Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1063221869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ESTANCIAS DE MONTE RIO 21 CALLE HELICONIA",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "00736",
            "telephone_number": "787-420-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. VILLA GRILLASCA 2178 BLVD. LUIS A. FERRE",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007170722",
            "telephone_number": "939-588-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILES ORTEGA",
        "first_name": "WILFREDO",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-06",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "8101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.