Individual provider Active NPI

Pablo Jose Martinez, PH. D.

  • Psychologist
  • Guaynabo, PR
National Provider Identifier
1073735239
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1911 Issued in PR
Practice address
L-1123 Urb. Munoz Rivera
Guaynabo, PR 00969
Phone
(787) 614-5246
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1911 PR Primary

Addresses

Primary practice location

L-1123 Urb. Munoz Rivera
Guaynabo, PR 00969

Mailing address

L-1123 Urb. Munoz Rivera
Guaynabo, PR 00969
Phone (787) 614-5246

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240821000383 PR Practitioner - Clinical Psychologist 4486192903 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1911PRMDRenal Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Servicios Primarios de Salud,Inc. Current Accepting new patients
Centro de Servicios Primarios de Salud,Inc. CurrentSince Jul 16, 2024 Accepting new patients
Centro de Servicios Primarios de Salud Inc CurrentSince Jul 16, 2024 Accepting new patients

Locations

3 Calle Antonio Alcazar
Florida, PR 00650
Phone (787) 822-2170

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073735239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "L-1123 URB. MUNOZ RIVERA",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-614-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "L-1123 URB. MUNOZ RIVERA",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-614-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "PABLO",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "1911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.