Individual provider Active NPI

Noel Ruiz Jimenez, PSYD

  • Clinical Psychologist
  • Vega Alta, PR
National Provider Identifier
1275864969
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3485 Issued in PR
Practice address
Edificio Brisas del Mar #1
Carr 693 KM 13.8
Vega Alta, PR 00692-9858
Phone
(787) 270-1420
NPI assigned
Jan 20, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 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 3485 PR Primary

Addresses

Primary practice location

Edificio Brisas del Mar #1
Carr 693 KM 13.8
Vega Alta, PR 00692-9858

Mailing address

115 Condominio Treasure Point
Vega Alta, PR 00692
Phone (787) 504-0519

Other identifiers 1

IdentifierTypeStateIssuer
38551301MedicaidPR

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
I20220531001486 PR Practitioner - Clinical Psychologist 2062890262 Reassigns benefits to 1 organization
Practice locations: Vega Alta, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3485PRMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Psiquiatrica Y Psicologica Felicita Ramos Clinical CurrentSince Feb 8, 2022 Accepting new patients
Aps Clinics of Puerto Rico, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1275864969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CONDOMINIO TREASURE POINT",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "00692",
            "telephone_number": "787-504-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EDIFICIO BRISAS DEL MAR #1",
            "address_2": "CARR 693 KM 13.8",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006929858",
            "telephone_number": "787-270-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ JIMENEZ",
        "first_name": "NOEL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-20",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38551301",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Alta, PR

Sources for this page

Verify at the official NPI Registry.