Individual provider Active NPI

Catalina Rosa Jacobs-Fernandez, PSY.D.

  • Psychologist
  • Coral Gables, FL
National Provider Identifier
1073533527
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY5925 Issued in FL
Practice address
101 Majorca Ave
Coral Gables, FL 33134-4508
Phone
(305) 807-2773
Fax
(305) 851-0253
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY5925 FL Primary

Addresses

Primary practice location

101 Majorca Ave
Coral Gables, FL 33134-4508

Mailing address

101 Majorca Ave
Coral Gables, FL 33134-4508
Phone (305) 807-0473

Other practice location 1

11880 Bird Rd
Suite 219
Miami, FL 33175-3584
Phone (305) 807-2773

Other identifiers 1

IdentifierTypeStateIssuer
54561AOtherFLBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041201000025 FL Practitioner - Psychologist Billing Independently 1456316546 Practice locations: Coral Gables, FL; Miami, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

101 Majorca Ave
Coral Gables, FL 33134-4508
Phone (305) 807-2773

11880 SW 40TH St
Suite 219
Miami, FL 33175-3574
Phone (305) 221-9921

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Catalina Jacobs-Fernandez, Psy.D. LLC Psychologist Current Accepting new patients
George F Ferrandiz Inc PastSince Sep 29, 2012 Accepting new patients

Locations

11880 SW 40th St
Ste 219
Miami, FL 33175
Phone (305) 221-9921

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1073533527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAJORCA AVE",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344508",
            "telephone_number": "305-807-0473",
            "fax_number": "305-851-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAJORCA AVE",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344508",
            "telephone_number": "305-807-2773",
            "fax_number": "305-851-0253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11880 Bird Rd",
            "address_2": "Suite 219",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331753584",
            "country_code": "US",
            "telephone_number": "305-807-2773",
            "fax_number": "305-851-0253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS-FERNANDEZ",
        "first_name": "CATALINA",
        "middle_name": "ROSA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "54561A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.