Individual provider Active NPI

Wilmarie Rivera, PSY.D.

  • Clinical Psychologist
  • Caguas, PR
National Provider Identifier
1104122092
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3937 Issued in PR
Practice address
3 Carr 172, KM 19.6
Bo Canaboncito
Caguas, PR 00727
Phone
(787) 661-0800
NPI assigned
Feb 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3937 PR Primary

Addresses

Primary practice location

3 Carr 172, KM 19.6
Bo Canaboncito
Caguas, PR 00727

Mailing address

376 Camino de Los Flamboyanes
Cidra, PR 00739-9444
Phone (787) 661-0800

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
I20110504000072 PR Practitioner - Clinical Psychologist 1355526542 Reassigns benefits to 2 organizations
Practice locations: Caguas, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3937PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Multidisciplinary Psychological Services, P.S.C. Psychologist CurrentSince Jul 1, 2023 Accepting new patients
Mental Care LLC Clinical CurrentSince Nov 29, 2023 Accepting new patients

Locations

1353 Ave Luis Vigoreaux
Guaynabo, PR 00966

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": "1297296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1104122092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 CAMINO DE LOS FLAMBOYANES",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007399444",
            "telephone_number": "787-661-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CARR 172, KM 19.6",
            "address_2": "BO CANABONCITO",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00727",
            "telephone_number": "787-661-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "WILMARIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-10",
        "last_updated": "2024-05-02",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.