Individual provider Active NPI

Axel David Reyes Vazquez

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1093327439
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7598 Issued in PR
Practice address
55E Calle Salmon
Ponce, PR 00716-8112
Phone
(787) 374-8390
NPI assigned
Aug 18, 2020
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7598 PR Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

55E Calle Salmon
Ponce, PR 00716-8112

Mailing address

Idamaris Gardens Calle Juan M Morales L-19
Caguas, PR 00727
Phone (787) 374-8390

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
I20230109000870 PR Practitioner - Clinical Psychologist 1052781010 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7598PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Behavioral Care Corp. Current Accepting new patients
Inspira Behavioral Care Corp CurrentSince Nov 22, 2022 Accepting new patients
Inspira Behavioral Care Corp. CurrentSince Nov 22, 2022 Accepting new patients
Coalicion de Coaliciones Pro Personas Sin Hogar de Puerto Rico, Inc PastSince Aug 1, 2020 Accepting new patients
Instituto Psicoterapeutico de PR PastSince Nov 22, 2022 Accepting new patients

Organizations & group practices 5

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": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1093327439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "IDAMARIS GARDENS CALLE JUAN M MORALES L-19",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00727",
            "telephone_number": "787-374-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55E CALLE SALMON",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007168112",
            "telephone_number": "787-374-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES VAZQUEZ",
        "first_name": "AXEL",
        "middle_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-18",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "7598",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.