Jacob Christopher Matos-Castro, PSYD
Individual provider Active NPI Clinical Psychologist · Ponce, PR
NPI 1104605955 · NPPES record last updated Apr 8, 2026
Key facts
- NPI
- 1104605955
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 7020 (PR)
- Practice address
- 388 Zona Ind Reparada 2
Ponce, PR 00716-2347 - Phone
- (787) 840-2575
- NPI assigned
- Sep 21, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231130002099 | PR | Practitioner - Clinical Psychologist | 0042668063 |
Reassigns benefits to 1 organization Practice locations: Ponce, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7020 | PR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tiber Health, Public Benefit Corporation | Current |
Accepting new patients | |
| Tiber Health, Public Benefit Corporation | Current |
Accepting new patients | |
| Tiber Health, Public Benefit Corporation | Clinical | Current |
Accepting new patients |
| Arist Medical Sciences University, Public Benefit Corporation | Past | Accepting new patients | |
| Ponce Health Sciences University | Past |
Accepting new patients |
Locations
388 Zona Ind Reparada 2
Ponce, PR 00716
Phone (787) 813-5700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 7020 | PR | Yes |
Addresses
Primary practice location
388 Zona Ind Reparada 2
Ponce, PR 00716-2347
Mailing address
Valle Alto Calle Pradera 1219
Ponce, PR 00730-4122
Phone (787) 951-6602
Other practice location 1
Calle Salmon #55 E
Ponce, PR 00716
Phone (787) 951-6602
Other providers in Ponce, PR
- Jorge R Matos Figueroa
- Gabriela N Matos Ortiz
- Eduardo Matos Postigo Sr.
- Stephanie Matos Quintana
- Jelisse Matos Renta
- Alexander Matos
- Barbara Matos
- Juan Edgardo Matos
- Marylin Matos
- Lucia Mattei Soto
All providers in Ponce, PR · Clinical Psychologist in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.