Individual provider Active NPI

Main Yie Quan Vega, PH.D.

  • Clinical Psychologist
  • Carolina, PR
National Provider Identifier
1194097147
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3284 Issued in PR
Practice address
3409 Ave Isla Verde Apt 1103
Carolina, PR 00979-4903
Phone
(787) 923-3708
NPI assigned
Feb 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 11845 FL
Clinical Psychologist 103TC0700X 3284 PR Primary

Addresses

Primary practice location

3409 Ave Isla Verde Apt 1103
Carolina, PR 00979-4903

Mailing address

PO Box 203
Box Elder, SD 57719-0203
Phone (605) 867-3162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151112000893 PR Practitioner - Clinical Psychologist 8022328558 Practice locations: San Juan, PR
I20191104002184 TX Practitioner - Clinical Psychologist 8022328558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.82
Promoting interoperability
91
Improvement activities
40
Cost
84.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
11845FLMDClinical Psychologist
3284PRMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Aug 20, 2019 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Aug 20, 2019 Accepting new patients

Organizations & group practices 3

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": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1194097147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 203",
            "city": "BOX ELDER",
            "state": "SD",
            "postal_code": "577190203",
            "telephone_number": "605-867-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 AVE ISLA VERDE APT 1103",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009794903",
            "telephone_number": "787-923-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAN VEGA",
        "first_name": "MAIN",
        "middle_name": "YIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-07",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "11845",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.