Active NPI
Marcos Javier Reyes-Estrada, PHD
- Clinical Psychologist
- San Juan, PR
National Provider Identifier
1154867190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5712
- Practice address
- 550 Calle Sergio Cuevas Bustamante
Esq. Ave Domenech
San Juan, PR 00918-2637 - Phone
- (787) 602-1287
- NPI assigned
- Jan 15, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 | 5712 | PR | Primary |
Addresses
Primary practice location
550 Calle Sergio Cuevas Bustamante
Esq. Ave Domenech
San Juan, PR 00918-2637
Mailing address
6 Hacienda Las Ceibas
Los Romeros
San Juan, PR 00926
Phone (787) 328-7009
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5712 | PR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687305600000",
"number": "1154867190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 HACIENDA LAS CEIBAS",
"address_2": "LOS ROMEROS",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00926",
"telephone_number": "787-328-7009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 CALLE SERGIO CUEVAS BUSTAMANTE",
"address_2": "ESQ. AVE DOMENECH",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009182637",
"telephone_number": "787-602-1287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES-ESTRADA",
"first_name": "MARCOS",
"middle_name": "JAVIER",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-15",
"last_updated": "2023-06-21",
"certification_date": "2023-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "5712",
"primary": true
}
],
"identifiers": [],
"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 Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.