Individual provider Active NPI

Jose Alfredo Aquino Sr., MA

  • Psychologist
  • Guaynabo, PR
National Provider Identifier
1073679700
Registry record updated Dec 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1772 Issued in PR
Practice address
140 Ave Las Cumbres Ste 201
Guaynabo, PR 00969-5527
Phone
(787) 235-9030
Fax
(782) 287-3509
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 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 1772 PR Primary

Addresses

Primary practice location

140 Ave Las Cumbres Ste 201
Guaynabo, PR 00969-5527

Mailing address

PO Box 486
Guaynabo, PR 00970-0486
Phone (787) 235-9030

Other identifiers 3

IdentifierTypeStateIssuer
2039178OtherPRCIGNA
734OtherPRHUMANA HEALTHPLANS
149867OtherPRFHC HEALTHSYSTEMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1772PRMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546128000000",
    "number": "1073679700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 486",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009700486",
            "telephone_number": "787-235-9030",
            "fax_number": "787-287-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 AVE LAS CUMBRES STE 201",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009695527",
            "telephone_number": "787-235-9030",
            "fax_number": "782-287-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AQUINO",
        "first_name": "JOSE",
        "middle_name": "ALFREDO",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2018-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "1772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2039178",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA HEALTHPLANS",
            "identifier": "734",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FHC HEALTHSYSTEMS",
            "identifier": "149867",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.