Jaisselle Marie Vega Rosaly, PHD

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

5738 Issued in PR

Practice address

775 Calle Caoba
Centro Comercial Los Caobos, Suite 6
Ponce, PR 00716-2610

Phone

(787) 677-0503

NPI assigned

Jul 25, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Mente Activa

  • Cognitive & Behavioral Psychologist
  • Ponce, PR
  • NPI 1023561230
  Medicare reassignment NPD

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1104379320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 CALLE CAOBA",
            "address_2": "CENTRO COMERCIAL LOS CAOBOS, SUITE 6",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007162610",
            "telephone_number": "787-677-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 CALLE CAOBA",
            "address_2": "CENTRO COMERCIAL LOS CAOBOS, SUITE 6",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007162610",
            "telephone_number": "787-677-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA ROSALY",
        "first_name": "JAISSELLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "PR",
            "license": "5738",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "5738",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos Antonio Vega Chacon
• Milva Vega Garcia
• Paola Natalia Vega Gonzalez
• Josue Vega Mateo, MD
• Ivonne Vega Mercado
• Dalishka Nahir Vega Santiago
• Rose M Vega Sotomayor, PT
• Julio David Vega Torres, PHD
• Tania Vega Valentin
• Jorge William Vega Velez

• Cognitive & Behavioral Psychologist in Ponce, PR
• Providers in Ponce, PR by specialty
• Cognitive & Behavioral Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.