Active NPI
Jennifer Marie Perez Rivera
- Clinical Psychologist
- Ponce, PR
National Provider Identifier
1235818436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 7729
- Practice address
- Galeria Profesional
Suite 102 Calle Concordia
Ponce, PR 00717-1562 - Phone
- (939) 835-7257
- NPI assigned
- Jul 14, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Clinical Psychologist | 103TC0700X | 7729 | PR | Primary |
Addresses
Primary practice location
Galeria Profesional
Suite 102 Calle Concordia
Ponce, PR 00717-1562
Mailing address
444 Parc Irizarry
Adjuntas, PR 00601
Phone (939) 366-0225
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231005001378 | PR | Practitioner - Clinical Psychologist | 2264887637 | Practice locations: Ponce, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7729 | PR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692921600000",
"number": "1235818436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "444 PARC IRIZARRY",
"city": "ADJUNTAS",
"state": "PR",
"postal_code": "00601",
"telephone_number": "939-366-0225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "GALERIA PROFESIONAL",
"address_2": "SUITE 102 CALLE CONCORDIA",
"city": "PONCE",
"state": "PR",
"postal_code": "007171562",
"telephone_number": "939-835-7257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ RIVERA",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-14",
"last_updated": "2023-08-25",
"certification_date": "2023-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "7729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
- Lorianne Alejandra Perez Perez, DC
- Derek Perez Pieraldi, PSYD
- Luis Manuel Perez Portocarrero, MD, MS
- Mariela Perez Quintana, MD
- Adriana G. Perez Rivera, PHARM.D.
- Eduardo Perez Rodriguez, M.D.
- Heidi Marie Perez Roman, M.D.
- Michelle Marielle Perez Roman
- Edgar Ivan Perez Ruiz, CSW
- Alejandro Luis Perez Torres, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.