Individual provider Active NPI

Nelson Barrios Feliciano, PSICOLOGO

  • Clinical Child & Adolescent Psychologist
  • Carolina, PR
National Provider Identifier
1215030382
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
1846 Issued in PR
Practice address
23-7 Ave Roberto Clemente
Carolina, PR 00985-5413
Phone
(787) 364-9688
Fax
(939) 697-6003
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 1846 PR Primary

Addresses

Primary practice location

23-7 Ave Roberto Clemente
Carolina, PR 00985-5413

Mailing address

1879 Calle Fermin Zedo
Urb Fair View
San Juan, PR 00926-7627
Phone (787) 364-9688

Other identifiers 7

IdentifierTypeStateIssuer
219012OtherPRPREFERRED HEALTH
075181OtherPRCRUZ AZUL
2034OtherPRHUMANA
2249319OtherPRCIGNA BEHAVIOR
2356OtherPRAPS HEALTH CARE
2357OtherPRMEDICARE MUCHO MAS
9766OtherPRINT MEDICARD CARD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040610000276 PR Practitioner - Psychologist Billing Independently 7810970142 Practice locations: Carolina, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23 -7 Ave Roberto Clemente
Carolina, PR 00985-5413
Phone (787) 400-3606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1215030382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1879 CALLE FERMIN ZEDO",
            "address_2": "URB FAIR VIEW",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009267627",
            "telephone_number": "787-364-9688",
            "fax_number": "939-697-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23-7 AVE ROBERTO CLEMENTE",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009855413",
            "telephone_number": "787-364-9688",
            "fax_number": "939-697-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRIOS FELICIANO",
        "first_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "PSICOLOGO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PR",
            "license": "1846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH",
            "identifier": "219012",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "075181",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "2034",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIOR",
            "identifier": "2249319",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APS HEALTH CARE",
            "identifier": "2356",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MUCHO MAS",
            "identifier": "2357",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INT MEDICARD CARD",
            "identifier": "9766",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.