Active NPI
Ivan Baez-Santos, PSYD
- Clinical Psychologist
- San German, PR
National Provider Identifier
1073937595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5390
- Practice address
- Carr. 361, KM. 1.4 Interior
San German, PR 00683-2318 - Phone
- (787) 615-0149
- NPI assigned
- Feb 5, 2014
- Last updated
- Feb 5, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5390 | PR | Primary |
Addresses
Primary practice location
Carr. 361, KM. 1.4 Interior
San German, PR 00683-2318
Mailing address
PO Box 2318
San German, PR 00683-2318
Phone (787) 615-0149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5390 | PR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391558400000",
"number": "1073937595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2318",
"city": "SAN GERMAN",
"state": "PR",
"postal_code": "006832318",
"telephone_number": "787-615-0149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR. 361, KM. 1.4 INTERIOR",
"city": "SAN GERMAN",
"state": "PR",
"postal_code": "006832318",
"telephone_number": "787-615-0149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAEZ-SANTOS",
"first_name": "IVAN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-05",
"last_updated": "2014-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "5390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San German, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.