Amidcar Jose Matos Irizarry, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

002415 Issued in PR

Practice address

1413 Ave Fernandez Juncos Suite 3C
San Juan, PR 00909-2616

Phone

(787) 362-3080

NPI assigned

Nov 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1154400067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URH TINTILLO GARDENS CALLE 6 H-16",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009660000",
            "telephone_number": "787-362-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 AVE FERNANDEZ JUNCOS SUITE 3C",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092616",
            "telephone_number": "787-362-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS IRIZARRY",
        "first_name": "AMIDCAR",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "002415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039710100",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yatzmeli Matias
• Jeysla Marie Matos Chaparro, MD
• Elizardo Matos Cruz, M.D.
• Ideliz Matos Cruz, M.A
• Roberto Carlos Matos Figueroa
• Gabriela Matos Maldonado, PHARMD
• Nancy Matos Ramos
• Zabdiel Matos Reyes, PHARMD
• Linka Matos Rivera, M.D.
• Chago V Matos Santiago, PH.D

• Clinical Psychologist in San Juan, PR
• Providers in San Juan, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.

Verify at the official NPI Registry.