Individual provider Active NPI

Delia Avelar, PSY.D.

  • Clinical Psychologist
  • Phoenix, AZ
National Provider Identifier
1073065900
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4814 Issued in AZ
Practice address
300 N 18TH St
Phoenix, AZ 85006-4103
Phone
(602) 606-9888
NPI assigned
Oct 26, 2016
Last updated
Jan 16, 2017By the provider in NPPES
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
Clinical Psychologist 103TC0700X 4814 AZ Primary

Addresses

Primary practice location

300 N 18TH St
Phoenix, AZ 85006-4103

Mailing address

300 N 18TH St
Phoenix, AZ 85006-4103
Phone (602) 606-9888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20180214001558 AZ Practitioner - Clinical Psychologist 4183984040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Park Health CenterGroup PAC ID 8325949647, 117 clinicians

Practice addresses (Care Compare)

6601 W Thomas Rd
Phoenix, AZ 85033-5700
Phone (602) 243-7277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4814AZMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Park Health Center CurrentSince Apr 1, 2018 Accepting new patients
Mountain Park Health Center Current Accepting new patients
Mountain Park Health Center CurrentSince Apr 1, 2018 Accepting new patients

Locations

2702 N 3rd St
Ste 4020
Phoenix, AZ 85004
Phone (602) 323-3345

3003 N Central Ave
Ste 1600
Phoenix, AZ 85012
Phone (602) 323-3492

635 E Baseline Rd
Phoenix, AZ 85042

6601 W Thomas Rd
Phoenix, AZ 85033

6601 W Thomas Rd
Ste 4
Phoenix, AZ 85033

Organizations & group practices 3

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": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1073065900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N 18TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850064103",
            "telephone_number": "602-606-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 18TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850064103",
            "telephone_number": "602-606-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVELAR",
        "first_name": "DELIA",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.