Individual provider Active NPI

Marilia Padua Quiles, PSY D

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1255967444
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6537 Issued in PR
Practice address
Galeria Profesional
Calle Concordia Suite 102
Ponce, PR 00717-1589
Phone
(939) 835-7257
NPI assigned
Mar 19, 2020
Last updated
Mar 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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 6537 PR Primary

Addresses

Primary practice location

Galeria Profesional
Calle Concordia Suite 102
Ponce, PR 00717-1589

Mailing address

3310 Calle Dorado
Urb Vista del Mar
Ponce, PR 00716
Phone (787) 318-5094

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200508001316 PR Practitioner - Clinical Psychologist 9830520717 Practice locations: Juan Diaz, PR; Ponce, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6537PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mindset Psychological & Consultant Group LLC Clinical CurrentSince Apr 6, 2025 Accepting new patients

Locations

8118 Calle Concordia
Ste 102
Ponce, PR 00717
Phone (787) 844-4600

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": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1255967444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 CALLE DORADO",
            "address_2": "URB VISTA DEL MAR",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00716",
            "telephone_number": "787-318-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GALERIA PROFESIONAL",
            "address_2": "CALLE CONCORDIA SUITE 102",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171589",
            "telephone_number": "939-835-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADUA QUILES",
        "first_name": "MARILIA",
        "credential": "PSY D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "6537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.