Individual provider Active NPI

Geysha M Menendez-Martinez, PSYD

  • Clinical Psychologist
  • Miami, FL
National Provider Identifier
1205900610
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY6744 Issued in FL
Practice address
9570 SW 107TH Ave
Suite 202C
Miami, FL 33176
Phone
(786) 391-1383
Fax
(786) 391-1384
NPI assigned
Nov 17, 2006
Last updated
Aug 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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 PY6744 FL Primary

Addresses

Primary practice location

9570 SW 107TH Ave
Suite 202C
Miami, FL 33176

Mailing address

9570 SW 107TH Ave
Suite 202C
Miami, FL 33176-2788
Phone (786) 391-1383

Other identifiers 2

IdentifierTypeStateIssuer
MH4680OtherFLLIC MENTAL HEALTH
PH6744OtherFLPSYCHOLOGIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040803000707 FL Practitioner - Psychologist Billing Independently 3577533009 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY6744FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Services & Consulting, Inc. Clinical CurrentSince Jul 4, 2017 Accepting new patients

Locations

9570 SW 107th Ave
Ste 202
Miami, FL 33176
Phone (786) 391-1383

9570 SW 107th Ave
Ste 202C
Miami, FL 33176
Phone (786) 391-1383

7928 SW 8th St
West Miami, FL 33144
Phone (305) 261-5000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1205900610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9570 SW 107TH AVE",
            "address_2": "SUITE 202C",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762788",
            "telephone_number": "786-391-1383",
            "fax_number": "786-391-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9570 SW 107TH AVE",
            "address_2": "SUITE 202C",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33176",
            "telephone_number": "786-391-1383",
            "fax_number": "786-391-1384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENENDEZ-MARTINEZ",
        "first_name": "GEYSHA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC MENTAL HEALTH",
            "identifier": "MH4680",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST",
            "identifier": "PH6744",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.