Individual provider Active NPI

Jose M Mendez-Villarrubia, PSY.D.

  • Clinical Psychologist
  • Mayaguez, PR
National Provider Identifier
1215153663
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2467 Issued in PR
Practice address
61 Calle Mendez Vigo
Suite 3a
Mayaguez, PR 00680
Phone
(787) 725-5013
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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 2467 PR Primary

Addresses

Primary practice location

61 Calle Mendez Vigo
Suite 3a
Mayaguez, PR 00680

Mailing address

320 Calle Puesta del Sol
Rincon, PR 00677-0000
Phone (787) 505-4086

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

State licenses

LicenseStateTypeSpecialty
002367CTMDProfessional Counselor
2467PRMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut PastSince Jul 16, 1998 Accepting new patients
West Health Care LLC Past Accepting new patients
State of Connecticut Past 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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1215153663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 CALLE PUESTA DEL SOL",
            "city": "RINCON",
            "state": "PR",
            "postal_code": "006770000",
            "telephone_number": "787-505-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 CALLE MENDEZ VIGO",
            "address_2": "SUITE 3A",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-725-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ-VILLARRUBIA",
        "first_name": "JOSE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.