Organization Active NPI

Optima Clinica Psicologica, PSC.

  • Psychologist
  • Bayamon, PR
National Provider Identifier
1285029728
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
OPTIMA CLINICA PSICOLOGICA, PSC.
Practice address
K1 Ave. Castiglioni
Urb. Bayamon Gardens
Bayamon, PR 00967-9998
Phone
(787) 395-7068
Fax
(787) 395-7076
NPI assigned
Apr 1, 2015
Last updated
Apr 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Authorized official

Name
Adalee Silva, PSYD
Title
Presidente
Phone
(787) 640-2408

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

K1 Ave. Castiglioni
Urb. Bayamon Gardens
Bayamon, PR 00967-9998

Mailing address

PO Box 1922
Bayamon, PR 00960-1922
Phone (787) 395-7068

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160113002113 PR Part B Supplier - Clinic/Group Practice 7012219660 Receives reassigned benefits from 2 practitioners
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

K1 Ave Castiglioni
Bayamon, PR 00957
Phone (787) 395-7068

1789 Carr 21
Ste 412
San Juan, PR 00921
Phone (787) 395-7068

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1285029728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1922",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009601922",
            "telephone_number": "787-395-7068",
            "fax_number": "787-395-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "K1 AVE. CASTIGLIONI",
            "address_2": "URB. BAYAMON GARDENS",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009679998",
            "telephone_number": "787-395-7068",
            "fax_number": "787-395-7076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMA CLINICA PSICOLOGICA, PSC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-01",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "SILVA",
        "authorized_official_first_name": "ADALEE",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-640-2408",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.