Active NPI
Carlos D Reyes Perez, PH.D.
- Clinical Psychologist
- San Juan, PR
National Provider Identifier
1124189063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2136
- Practice address
- Antonsanti 1605 Parada 23
San Juan, PR 00912 - Phone
- (787) 750-1991
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 2136 | PR | Primary |
Addresses
Primary practice location
Antonsanti 1605 Parada 23
San Juan, PR 00912
Mailing address
Antonsanti 1605 Parada 23
San Juan, PR 00912
Phone (787) 750-1991
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 57084 | Other | PR | TRIPLE S PROVIDER |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2136 | PR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124189063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ANTONSANTI 1605 PARADA 23",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00912",
"telephone_number": "787-750-1991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ANTONSANTI 1605 PARADA 23",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00912",
"telephone_number": "787-750-1991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES PEREZ",
"first_name": "CARLOS",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "2136",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIPLE S PROVIDER",
"identifier": "57084",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.