Individual provider Active NPI

Marianyelis Mendoza-Orama

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1124596846
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7193 Issued in PR
Practice address
2431 Blvd Luis a Ferre Ste 205
Ponce, PR 00717-2115
Phone
(787) 848-5050
NPI assigned
Nov 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 7193 PR Primary

Addresses

Primary practice location

2431 Blvd Luis a Ferre Ste 205
Ponce, PR 00717-2115

Mailing address

2431 Blvd Luis a Ferre Ste 205
Ponce, PR 00717-2115
Phone (787) 848-5050

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7193PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Behavioral Care Corp. Past Accepting new patients
Inspira Behavioral Care Corp PastSince Nov 17, 2024 Accepting new patients

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": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1124596846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 BLVD LUIS A FERRE STE 205",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007172115",
            "telephone_number": "787-848-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 BLVD LUIS A FERRE STE 205",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007172115",
            "telephone_number": "787-848-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA-ORAMA",
        "first_name": "MARIANYELIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "7193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.