Individual provider Active NPI

Sharleene Ruiz Pacheco, PSY.D.

  • Clinical Psychologist
  • Mayaguez, PR
National Provider Identifier
1174162903
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6573 Issued in PR
Practice address
PR #2 KM 159.0 Avenida Hostos 826
Edificio Villa Capitan III Suite 101
Mayaguez, PR 00680
Phone
(939) 499-5888
NPI assigned
Dec 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6573 PR Primary

Addresses

Primary practice location

PR #2 KM 159.0 Avenida Hostos 826
Edificio Villa Capitan III Suite 101
Mayaguez, PR 00680

Mailing address

3054 Mansiones
Calle Monaco C-33
Cabo Rojo, PR 00623
Phone (787) 519-8587

Other practice location 1

Torre Medica San Vicente de Paul Suite 307
San German, PR 00683
Phone (939) 499-5888

Other names 1

  • Dr. Sharleene Ruiz Pacheco Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200316000236 PR Practitioner - Clinical Psychologist 6507294154 Practice locations: Mayaguez, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

826 Avenida Hostos Villa Capitan III
Suite 101
Mayaguez, PR 00680

PR-2 KM
826 Edificio Villa Capitan III Suite 101
Mayaguez, PR 00680
Phone (939) 499-5888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6573PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bienestar Emocional PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 1

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": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1174162903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3054 MANSIONES",
            "address_2": "CALLE MONACO C-33",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "00623",
            "telephone_number": "787-519-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PR #2 KM 159.0 AVENIDA HOSTOS 826",
            "address_2": "EDIFICIO VILLA CAPITAN III SUITE 101",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "939-499-5888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Torre Medica San Vicente de Paul Suite 307",
            "address_purpose": "LOCATION",
            "city": "San German",
            "state": "PR",
            "postal_code": "00683",
            "country_code": "US",
            "telephone_number": "939-499-5888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ PACHECO",
        "first_name": "SHARLEENE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-26",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "6573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARLEENE",
            "last_name": "RUIZ PACHECO",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.